Yohei Kida, Takehiro Oiwa, Ryusuke Deguchi
Department of Internal Medicine Kainan Municipal Medical Center, 1522-1 Hikata, Kainan-City, 642 0002, Japan.
Department of Urology Kainan Municipal Medical Center, 1522-1 Hikata, Kainan-City, 642 0002, Japan.
IDCases. 2018 Aug 10;14:e00436. doi: 10.1016/j.idcr.2018.e00436. eCollection 2018.
A 61-year-old woman was evaluated because of 2 days of anuria, fever, anorexia, and progressive decline in mental status. On admission, she appeared confused with a GCS score of E2V2M4, and her blood ammonia level was elevated (176 μg/dL). Abdominal computed tomography showed bilateral hydronephrosis and bladder fullness with wall thickness in spite of indwelling bladder catheter. Her catheter was obstructed by blood clot. Blood cultures, blood clot culture, and one urine culture all yielded . Obstructive urinary tract infection complicated with septic shock was diagnosed. After treatment, her ammonia level normalized.
一名61岁女性因无尿2天、发热、厌食及精神状态进行性恶化而接受评估。入院时，她意识模糊，格拉斯哥昏迷量表（GCS）评分为E2V2M4，血氨水平升高（176μg/dL）。腹部计算机断层扫描显示双侧肾盂积水及膀胱胀满伴膀胱壁增厚，尽管已留置膀胱导管。她的导管被血凝块阻塞。血培养、血凝块培养及一次尿培养均培养出[具体结果未给出]。诊断为梗阻性尿路感染并发感染性休克。治疗后，她的血氨水平恢复正常。
