Thøgersen Thøger, Jensen Jørgen Erik, Jespersen Bente
Odense Universitetshospital, Nefrologisk Afdeling Y.
Ugeskr Laeger. 2003 Jun 16;165(25):2577-8.
Acute renal failure is a known complication to Salmonella gastroenteritis, and patients with chronic renal failure or impaired host defence are at increased risk. In the two presented cases there had been a few days of gastroenteritis before the hospitalisation, but the only symptoms at the admission were fatigue and dyspnoea. In both cases severe uraemia had developed and the patients and their physicians did not expect the episode of gastroenteritis to be the only etiology of acute renal failure. Both patients had normal renal histology and Salmonella was grown in their faeces. Subsequently, their renal function was normalised. In these patients dialysis and renal biopsies would have been unnecessary if the ability of even a moderate Salmonella infection to cause acute renal failure in a healthy subject had been realised and prompt rehydration had been initiated.
急性肾衰竭是沙门氏菌性肠胃炎已知的并发症,慢性肾衰竭或宿主防御功能受损的患者风险更高。在这两个病例中,住院前已有几天肠胃炎病史,但入院时的唯一症状是疲劳和呼吸困难。两个病例均已发展为严重尿毒症,患者及其医生并未料到肠胃炎发作会是急性肾衰竭的唯一病因。两名患者的肾脏组织学检查均正常,粪便中培养出沙门氏菌。随后,他们的肾功能恢复正常。如果认识到即使是中度沙门氏菌感染也可能在健康受试者中导致急性肾衰竭,并及时开始补液,那么对这些患者进行透析和肾活检就没有必要了。