Sato Junko, Koyano Hajime M, Sasaki Ruri, Koike Yoshie, Sugimura Sosuke, Watada Hirotaka
Division of Metabolism and Endocrinology, Department of Internal Medicine, Juntendo Urayasu Hospital, Urayasu.
Intern Med. 2010;49(21):2317-20. doi: 10.2169/internalmedicine.49.4000. Epub 2010 Nov 1.
Multiple tumors in the liver, kidney, and on the posterior side of the urinary bladder were accidentally found when a diabetic woman visited the hospital. She refused to undergo surgery; therefore, she was only observed for 2 months. Subsequently, she was found unconscious at home and diagnosed with urinary infection, sepsis, and hyperglycemic hyperosmolar non-ketotic coma. The case followed a fulminant course, and she soon died. Postmortem computed tomography revealed emphysematous pyelonephritis (EPN), a rare, life-threatening infection. This case highlights the importance of carefully managing infection in diabetic patients, and it may contribute to clarifying the pathogenesis of EPN.
一名糖尿病女性患者到医院就诊时，意外发现肝脏、肾脏及膀胱后侧有多处肿瘤。她拒绝接受手术，因此仅接受了2个月的观察。随后，她在家中被发现昏迷，被诊断为尿路感染、脓毒症和高渗高血糖非酮症昏迷。该病例病情发展迅猛，她很快死亡。尸检计算机断层扫描显示为气肿性肾盂肾炎（EPN），这是一种罕见的、危及生命的感染。该病例凸显了谨慎处理糖尿病患者感染的重要性，可能有助于阐明EPN的发病机制。
