Nephrotic syndrome is known to cause hypercoagulation due to various factors. Steroid therapy is considered the main treatment for nephrotic syndrome. However, this can increase the risk of developing venous thromboembolism, prompting caution in its use. Here, we report a case of venous thromboembolism in a 13-year-old girl with acute renal failure. This developed during catheter insertion into the right internal jugular vein for hemodialysis. We initiated direct oral anticoagulant therapy. Ultrasound was used to monitor the jugular vein.Throughout the course of treatment, the venous thrombosis gradually disappeared. This study highlights the importance of considering prophylactic anticoagulant therapy in patients with nephrotic syndrome who have an increased risk of venous thromboembolism during central venous catheter placement.
In Japan, pneumococcal vaccine has been routinely administered since 2010 to prevent invasive pneumococcal diseases such as Streptococcus pneumoniae meningitis. We describe a case of pneumococcal meningitis in a 7-month-old girl who had received three doses of 13-valent pneumococcal conjugate vaccine. Brain magnetic resonance imaging showed infarcts in the right frontal region, and she was treated with antibiotics, intravenous immunoglobulin, dexamethasone, and edaravone. On day 27, an enhanced brain CT scan showed improvement of abnormal findings in the frontal region, except for slight atrophy. The S. pneumoniae serotype was 12F, which is not included in the 13-valent pneumococcal conjugate vaccine. A future vaccine is expected to use cross-reactivity to target common antigens. (J
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