Department of Molecular Endocrinology and Metabolism Graduate School of Medical and Dental Sciences Tokyo Japan.
Department of Molecular Endocrinology and Metabolism Graduate School of Medical and Dental Sciences Tokyo Japan; Center for Medical Welfare and Liaison Services Tokyo Medical and Dental University Tokyo Japan.
J Diabetes Investig. 2016 May;7(3):436-9. doi: 10.1111/jdi.12375. Epub 2015 Jun 22.
We present a case of a 62-year-old diabetic woman with acute pyelonephritis and spondylitis caused by Salmonella typhi. She was admitted to Tokyo Medical Dental University Hospital, Tokyo, Japan, because of unconsciousness and was diagnosed with sepsis by retrograde pyelonephritis as a result of Salmonella typhi. Antibiotics treatment was immediately started; however, she subsequently developed lumbar spondylitis, and long-term conservative treatment with antibiotics and a fixing device were required. This is the first report of a diabetic patient who developed retrograde urinary tract infection with Salmonella typhi, followed by sepsis and spondylitis. The infection could be a result of diabetic neuropathy, presenting neurogenic bladder and hydronephrosis. The patient was successfully treated with antibiotics and became asymptomatic with normal inflammatory marker levels, and no clinical sign of recurrence was observed in the kidney and spine at 4 months.
我们报告了一例 62 岁的糖尿病女性患者，因伤寒沙门氏菌引起急性肾盂肾炎和脊椎炎。她因意识不清被收入日本东京医科齿科大学医院，被诊断为逆行性肾盂肾炎导致的败血症。立即开始使用抗生素治疗；然而，她随后出现了腰椎脊椎炎，需要长期使用抗生素和固定装置进行保守治疗。这是首例糖尿病患者发生伤寒沙门氏菌逆行性尿路感染，继而发生败血症和脊椎炎的报告。感染可能是糖尿病性神经病引起的，表现为神经性膀胱和肾积水。该患者经抗生素治疗成功，炎症标志物水平正常，无任何症状，4 个月后肾脏和脊柱均无复发迹象。
