Kanemiya Taketoshi, Arai Hiroki, Murosaki Nobukazu, Honda Masahito, Osaki Tadashi, Hara Hiroko, Yoshida Kyotaro
The Department of Urology, Kinki Chuo Hospital, Japan.
Hinyokika Kiyo. 2012 Mar;58(3):155-8.
A 55-year-old man was hospitalized for pneumonia. His fever did not subside despite administration of antibiotics ; therefore, he was referred to our hospital. A chest radiograph and thoracic computed tomography showed multiple tubercles ; abdominal computed tomography (CT) showed left renal abscess. The patient's temperature fell after antibiotic administration, but inflammation reaction exacerbated. Abdominal CT showed inflammation spreading to the subcutaneous tissues. We considered renal resection, but the patient could not be administered general anesthesia because of low breathing function caused by pneumonia. We attempted open drainage and wedge resection of the left renal under local anesthesia ; but we were not able to identify the infectious bacteria. Four days later, the patient had blood poisoning and died because of deterioration of breathing function. Actinomyces was detected in the lungs and the kidneys by pathological examination.
一名55岁男性因肺炎住院。尽管使用了抗生素，他的发热仍未消退；因此，他被转诊至我院。胸部X光片和胸部计算机断层扫描显示有多个结节；腹部计算机断层扫描（CT）显示左肾脓肿。使用抗生素后患者体温下降，但炎症反应加剧。腹部CT显示炎症蔓延至皮下组织。我们考虑进行肾切除术，但由于肺炎导致呼吸功能低下，患者无法接受全身麻醉。我们尝试在局部麻醉下对左肾进行开放引流和楔形切除术；但未能鉴定出感染细菌。四天后，患者发生败血症，因呼吸功能恶化而死亡。病理检查在肺部和肾脏中检测到放线菌。
