Miyaki Junya, Souma Shinya, Narumiya Yasuyuki, Chiba Shigehiro, Kugiyama Kiyotaka
Department of Respiratory Medicine, Yamanashi Kousei Hospital.
Nihon Kokyuki Gakkai Zasshi. 2006 Nov;44(11):879-84.
A 69-year-old man who had benign prostatic hypertrophy and hypertension was admitted to our hospital because of urinary retention and high grade fever. Chest radiograph showed the appearance of multiple cavitating nodules in both lung fields within a few days after admission. Staphylococcus aureus was isolated in blood and sputum cultures, though there were no pathogens in urine culture. Abdominal CT demonstrated bilateral hydronephrosis. Since we could not detect any other infectious focuses such as bacterial endocarditis, septic thrombophlebitis etc., we reached the diagnosis of septic pulmonary embolism (SPE) induced by urinary tract infection (UTI). After diagnosis, the patient was given intravenous meropenem, ciprofloxacin, sulbactam/ampicilin, and recovered. Although several cases of SPE induced by UTI in diabetes mellitus patients have been reported, the present case who had no severe underlying disorder is very rare.
一名患有良性前列腺增生和高血压的69岁男性因尿潴留和高热入住我院。入院后数天胸部X线片显示双肺野出现多个空洞性结节。血培养和痰培养分离出金黄色葡萄球菌,而尿培养未发现病原体。腹部CT显示双侧肾盂积水。由于我们未检测到任何其他感染灶,如细菌性心内膜炎、脓毒性血栓性静脉炎等,我们诊断为由尿路感染(UTI)引起的脓毒性肺栓塞(SPE)。诊断后,给予患者静脉注射美罗培南、环丙沙星、舒巴坦/氨苄西林,患者康复。虽然已有数例糖尿病患者由UTI引起SPE的报道,但本病例无严重基础疾病,非常罕见。