肺炎球菌感染与溶血性尿毒症综合征
Pneumococcal infection and hemolytic uremic syndrome.
作者信息
Tinsa Faten, Siala Nadia, Ncibi Nesrine, Fetni Ilhem, Kasdalli Kalthoum, Ben Jballah Najla, Mehrezi Ahmed
机构信息
Department of Pediatrics B of the Children s Hospital of Tunis Department of Pediatrics, Monji Slim Hospital, Tunis.
出版信息
Tunis Med. 2009 Nov;87(11):790-2.
BACKGROUND
Hemolytic uremic syndrome, one of the common causes of acute renal failure in children, is characterized by the triad of microangiopathy, haemolytic anemia, thrombocytopenia and acute renal failure. The diarrhoea-associated Hemolytic uremic syndrome is usually termed as a typical Hemolytic uremic syndrome. Streptococcus pneumoniae is an uncommon etiological pathogen for inducing Hemolytic uremic syndrome, and Streptococcus pneumoniae associated Hemolytic uremic syndrome is also termed as atypical hemolytic uremic syndrome.
AIM
to report two pediatric cases of invasive S pneumoniae complicated with hemolytic uremic syndrome HUS.
CASE REPORT
The first patient presented with pneumococcal pneumonia and empyema and the second patient presented with pneumococcal pneumonia and meningitis. The two patients were under one year of age and required peritoneal dialysis with improvement of renal function in one; the other died.
CONCLUSION
Pneumococcal invasive disease may be a cause of severe HUS, so a high index of suspicion is mandatory to prompt appropriate diagnosis and management.
背景
溶血尿毒综合征是儿童急性肾衰竭的常见病因之一，其特征为微血管病、溶血性贫血、血小板减少和急性肾衰竭三联征。腹泻相关的溶血尿毒综合征通常被称为典型溶血尿毒综合征。肺炎链球菌是诱发溶血尿毒综合征的罕见病原体，肺炎链球菌相关的溶血尿毒综合征也被称为非典型溶血尿毒综合征。
目的
报告两例侵袭性肺炎链球菌并发溶血尿毒综合征（HUS）的儿科病例。
病例报告
首例患者表现为肺炎球菌性肺炎和脓胸，第二例患者表现为肺炎球菌性肺炎和脑膜炎。两名患者均未满一岁，其中一名需要进行腹膜透析，肾功能有所改善；另一名死亡。
结论
肺炎球菌侵袭性疾病可能是严重HUS的病因之一，因此必须高度怀疑以促使进行适当的诊断和管理。
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