Khan Fahmi Yousef, Al-Ani Ahmed, Ali Hamda Abdulla
Department of Medicine, Hamad General Hospital, Doha-Qatar.
Int J Infect Dis. 2009 Sep;13(5):e282-5. doi: 10.1016/j.ijid.2008.11.009. Epub 2009 Jan 14.
We report a case of typhoid rhabdomyolysis with acute renal failure and acute pancreatitis in a 23-year-old Vietnamese male who was admitted to the intensive care unit with a 15-day history of fever followed by severe abdominal pain. On examination, the patient was febrile and his abdomen was diffusely tender. Serum creatinine was 533 micromol/L, pancreatic amylase 1800 U/L and lipase 900 U/L; the myoglobin blood level was high, which is associated with significant myoglobinuria. Blood, urine and stool culture yielded Salmonella enterica serovar typhi, which was sensitive to ceftriaxon, ampicillin and ciprofloxacin. Ceftriaxon was initiated for a total of 14 days. Subsequently, the patient maintained a good urine output with improved renal parameters and accordingly was discharged. In this report, we review the literature and discuss the pathogenesis of the disease thoroughly.
我们报告一例23岁越南男性伤寒性横纹肌溶解症合并急性肾衰竭和急性胰腺炎的病例。该患者因发热15天，随后出现严重腹痛入住重症监护病房。检查发现，患者发热，腹部弥漫性压痛。血清肌酐为533微摩尔/升，胰腺淀粉酶1800单位/升，脂肪酶900单位/升；肌红蛋白血水平升高，伴有明显的肌红蛋白尿。血、尿和粪便培养均检出伤寒沙门菌，对头孢曲松、氨苄西林和环丙沙星敏感。给予头孢曲松治疗共14天。随后，患者尿量维持良好，肾功能指标改善，因此出院。在本报告中，我们回顾了文献并深入讨论了该疾病的发病机制。
