期刊
INTERNAL MEDICINE
卷 59, 期 15, 页码 1849-1853出版社
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.4593-20
关键词
hepatic encephalopathy; liver cirrhosis; poorly absorbed antibiotics; small intestinal bacterial overgrowth
A 66-year-old Japanese man was admitted to our hospital with grade 2 hepatic encephalopathy (HE). Abdominal computed tomography and laboratory examinations revealed decompensated liver cirrhosis. Intravenous administration of branched-chain amino acids immediately ameliorated the HE, and lactulose was initiated. However, a breath test revealed small intestinal bacterial overgrowth (SIBO); therefore, rifaximin was additionally initiated. The breath test was repeated after discharge, when no evidence of SIBO or overt HE was identified. This case suggested that a breath test is effective for the identification of SIBO and that the administration of a poorly absorbed antibiotic should be considered in SIBO-positive HE patients taking lactulose.
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