Hayashi Shintaro, Mori Akihiro, Kawamura Takuya, Ito Shun, Shibuya Takashi, Fushimi Nobutoshi
Department of Internal Medicine, Ichinomiya-Nishi Hospital, Japan.
Intern Med. 2015;54(17):2219-23. doi: 10.2169/internalmedicine.54.4607. Epub 2015 Sep 1.
A 45-year-old woman under home parenteral nutrition was admitted with recurrent fever and a worsening renal function. A diagnosis of central venous catheter-related blood stream infection (CVCRBSI) was made according to the identification of coagulase-negative Staphylococcus from both the peripheral blood and the removed CV catheter, along with an improvement of the symptoms following the removal of the catheter. Renal impairment with hypocomplementemia was thought to be secondary to the immune complex formation and deposition in the kidneys in response to prolonged bacteremia. This was confirmed by the pathological findings. Clinicians should therefore be aware that glomerulonephritis may be induced by long-term CVCRBSI.
一名接受家庭肠外营养的45岁女性因反复发热和肾功能恶化入院。根据外周血和拔除的中心静脉导管中均鉴定出凝固酶阴性葡萄球菌，以及拔除导管后症状改善，诊断为中心静脉导管相关血流感染（CVCRBSI）。肾功能损害伴低补体血症被认为是由于长期菌血症导致免疫复合物在肾脏形成和沉积所致。病理结果证实了这一点。因此，临床医生应意识到长期CVCRBSI可能诱发肾小球肾炎。
