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钩端螺旋体病与肾衰竭:病例系列

Leptospirosis and renal failure: a case series.

作者信息

Windpessl Martin, Prammer Wolfgang, Nömeyer Roland, Dinkhauser Patrick, Wimmer Ludwig, Müller Petra, Gusenleitner Julia, Wallner Manfred

机构信息

Division of Nephrology, Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Grieskirchnerstrasse 42, 4600, Wels, Austria,

出版信息

Wien Klin Wochenschr. 2014 Apr;126(7-8):238-42. doi: 10.1007/s00508-014-0501-0. Epub 2014 Feb 5.

Abstract

Leptospirosis is a ubiquitous and potentially fatal zoonosis with protean manifestations. Human infection commonly occurs through contact with contaminated water or soil. In developed countries, leisure or household activities are increasingly associated with the disease. Within few months, we encountered five unrelated and autochthonous cases of severe leptospirosis, three of them requiring interim dialysis. In this case series, we present their clinical course. Furthermore, we provide an overview on the spectrum of organ involvement, with an emphasis on kidney injury, and comment on pitfalls in establishing the diagnosis. The considerable variance in presentation-with admissions both to internal and neurological units-emphasises the high index of suspicion required to arrive at the right diagnosis, particularly in countries of perceived low risk such as Austria.

摘要

钩端螺旋体病是一种普遍存在且可能致命的人畜共患病,临床表现多样。人类感染通常通过接触受污染的水或土壤发生。在发达国家,休闲或家庭活动与该病的关联日益增加。在短短几个月内,我们遇到了5例无关的本地严重钩端螺旋体病病例,其中3例需要临时透析。在本病例系列中,我们介绍了它们的临床病程。此外,我们概述了器官受累的范围,重点是肾损伤,并对诊断过程中的陷阱进行了评论。临床表现差异很大——患者分别入住内科和神经科病房——这强调了做出正确诊断所需的高度怀疑指数,尤其是在像奥地利这样被认为风险较低的国家。

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