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表现为尿皮肤瘘的肾放线菌病。

Renal actinomycosis presenting as uro-cutaneous fistula.

作者信息

Diab Christian, Almarzouq Ahmad, Ajise Oluyomi, Barkati Sapha, Tchervenkov Jean, Andonian Sero

机构信息

Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.

Division of Pathology, McGill University, Montreal, QC, Canada.

出版信息

Urol Case Rep. 2019 Oct 17;28:101054. doi: 10.1016/j.eucr.2019.101054. eCollection 2020 Jan.

DOI:10.1016/j.eucr.2019.101054
PMID:31709154
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6833357/
Abstract

Renal actinomycosis is a rare clinical entity. Diagnosis is usually made after resection. A 36-year-old male presented with uro-cutaneous fistula and left xanthogranulomatous pyelonephritis. He was offered left open radical nephrectomy. Intra-operatively, there was "woody" inflammation of the left kidney fistulizing to the splenic flexure of the colon. We successfully resected it and a segment of the colon that had fistulized. His tissue cultures grew . Post-operatively, he received 6 weeks of intravenous beta-lactam antibiotic. He recovered well without any complications. In conclusion, renal actinomycosis can be challenging to diagnose, operate and eradicate. Perioperative considerations are presented for successful management.

摘要

肾放线菌病是一种罕见的临床病症。诊断通常在切除术后做出。一名36岁男性出现尿皮肤瘘和左黄肉芽肿性肾盂肾炎。他接受了左开放性根治性肾切除术。术中,左肾有“木质样”炎症,与结肠脾曲形成瘘管。我们成功切除了病变及发生瘘管的一段结肠。他的组织培养有生长。术后,他接受了6周的静脉注射β-内酰胺抗生素治疗。他恢复良好,无任何并发症。总之,肾放线菌病在诊断、手术和根除方面可能具有挑战性。本文介绍了成功管理的围手术期注意事项。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd65/6833357/fc63247ea356/egi10DPP6WN7F8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd65/6833357/89eff085216a/egi10TDS6W8PFC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd65/6833357/1d2021009fee/egi10FW06NMXCR.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd65/6833357/fc63247ea356/egi10DPP6WN7F8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd65/6833357/89eff085216a/egi10TDS6W8PFC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd65/6833357/1d2021009fee/egi10FW06NMXCR.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd65/6833357/fc63247ea356/egi10DPP6WN7F8.jpg

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本文引用的文献

1
Actinomycosis: etiology, clinical features, diagnosis, treatment, and management.放线菌病:病因、临床特征、诊断、治疗和管理。
Infect Drug Resist. 2014 Jul 5;7:183-97. doi: 10.2147/IDR.S39601. eCollection 2014.
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Actinomycosis.放线菌病
BMJ. 2011 Oct 11;343:d6099. doi: 10.1136/bmj.d6099.
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Medical management of renal actinomycosis.肾放线菌病的药物治疗
假体血管移植物感染(PVGI):多中心病例系列及文献叙述性综述
Microorganisms. 2023 Dec 6;11(12):2931. doi: 10.3390/microorganisms11122931.
J Urol. 2004 Jun;171(6 Pt 1):2373-4. doi: 10.1097/01.ju.0000124452.80578.3c.
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Actinomycosis of the large bowel: unusual presentations and their surgical treatment.大肠放线菌病:不寻常的表现及其外科治疗
Eur J Surg. 1996 Aug;162(8):657-60.
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Renal actinomycosis.肾放线菌病
Urology. 1976 Mar;7(3):309-11. doi: 10.1016/0090-4295(76)90466-0.