Lucarelli Lucas I, Alconchera Laura F
Hospital Interzonal General Dr. José Penna, Bahía Blanca, Buenos Aires, Argentina.
Arch Argent Pediatr. 2020 Jun;118(3):e305-e308. doi: 10.5546/aap.2020.e305.
Streptococcus pneumoniae associated hemolytic uremic syndrome (Sp-HUS) is defined as microangiopathic hemolytic anemia, thrombocytopenia and acute renal injury, in a patient with Streptococcus pneumoniae (Sp) invasive infection. A 2-year-old boy was admitted with pneumonia and empyema. Sp was isolated from blood and pleural fluid cultures. After 72 h, the patient showed paleness, asthenia, respiratory whining and oliguria. Laboratory showed anemia, low platelets, increased blood urea, creatirnina, lactate dehdrogenase, direct Coombs +, schistocytes, fibrinogen, normal coagulogram and increased D-dimer. Proteinuria and hematuria were detected in urine. Mechanical ventilatory assistance and transfusions of washed red blood cells were required. The patient recovered progressively. Sp serotype 38 was isolated in the National Reference Laboratory "Malbran". This is the first report associated to this serotype.
肺炎链球菌相关性溶血性尿毒症综合征（Sp-HUS）定义为肺炎链球菌（Sp）侵袭性感染患者出现微血管病性溶血性贫血、血小板减少和急性肾损伤。一名2岁男孩因肺炎和脓胸入院。血液和胸腔积液培养分离出Sp。72小时后，患者出现面色苍白、乏力、呼吸呻吟和少尿。实验室检查显示贫血、血小板减少、血尿素、肌酐、乳酸脱氢酶升高，直接抗人球蛋白试验阳性、裂体细胞、纤维蛋白原正常，凝血图正常，D-二聚体升高。尿液检测发现蛋白尿和血尿。需要机械通气支持和输注洗涤红细胞。患者逐渐康复。在国家“马尔布兰”参考实验室分离出Sp 38型。这是与该血清型相关的首例报告。
