Harrabi Hajer, Marrakchi Chakib, Daoud Emna, Elleuch Emna, Hammami Boussayma, Maâloul Imed, Lahiani Dorra, Mnif Jamel, Ben Jemâa Mounir
Service de maladies infectieuses, CHU Hédi Chaker, route El Aïn Km 0,5, 3029 Sfax, Tunisie.
Nephrol Ther. 2010 Nov;6(6):541-3. doi: 10.1016/j.nephro.2010.05.005. Epub 2010 Jul 21.
Acute emphysematous pyelonephritis (AEP) is a severe form of urinary tract infection. It occurs usually in diabetics. The most concerned agents are the Gram-negative bacilli. We report a first case of bilateral AEP due to Candida glabrata, occurred in a 64-year-old diabetic woman. The clinical presentation started with fever and abdominal pains, without signs of urinary tract infection. Within six hours, the patient had developed a septic shock with renal failure and ketoacidosis. The diagnosis was confirmed by CT scan and the pathogen was isolated in urine. Despite antibiotic and antifungal treatment, she died from a septic shock. Acute emphysematous pyelonephritis due to Candida species is rare. However, the addition of antifungal therapy seems justified if a severe emphysematous pyelonephritis is associated with risk factors of Candida infection.
急性气肿性肾盂肾炎(AEP)是一种严重的尿路感染形式。它通常发生在糖尿病患者中。最常见的病原体是革兰氏阴性杆菌。我们报告首例由光滑念珠菌引起的双侧AEP病例,发生在一名64岁的糖尿病女性身上。临床表现以发热和腹痛开始,无尿路感染迹象。在六小时内,患者发展为伴有肾衰竭和酮症酸中毒的感染性休克。CT扫描确诊,尿液中分离出病原体。尽管进行了抗生素和抗真菌治疗,她仍死于感染性休克。念珠菌属引起的急性气肿性肾盂肾炎很少见。然而,如果严重的气肿性肾盂肾炎伴有念珠菌感染的危险因素,添加抗真菌治疗似乎是合理的。