An 81-year-old man with complaints of dysphagia and weight loss was admitted to our hospital. Upper gastrointestinal endoscopy revealed advanced gastric cancer. Fever of unknown origin with leukocytosis persisted after admission. A granulocyte-colony stimulating factor (G-CSF)-producing gastric cancer was suspected because of elevated serum G-CSF levels. Surgery was performed in spite of the patient’s poor general condition. He went into acute respiratory distress from aspiration pneumonia after surgery and respiratory management with assisted ventilation was needed. Enteral feeding was difficult initially, but oral intake could eventually be resumed. The patient’s condition improved sufficiently to be discharged.

A 79-year-old woman with an infected pressure ulcer was admitted to our hospital. She had depression and poor nutritional status due to drug-induced dysphagia. To facilitate treatment of the pressure ulcer, improvement of nutritional status was preferable. Adjusting the psychotropic drugs led to improvement of both oral intake and the pressure ulcer. To prevent recurrence of pressure ulcer, the medical treatment environment needed to be improved. An important consideration was where she would receive medical treatment after discharge and included considering the burden on caregivers and the economic burden that this would impose. This case shows that a multifaceted approach can be effective for treating infected pressure ulcer in a patient with poor nutritional status and mental illness.