Zappacosta A R, Ashby B L
JAMA. 1977 Sep 26;238(13):1389-90.
Acute intrinsic renal failure occurred in an adult patient with Escherichia coli septicemia. The clinical course did not include any of the circumstances usually present when acute renal failure complicates Gram-negative sepsis. A renal biopsy showed acute proliferative glomerulonephritis. There was no evidence to support other known causes of acute parenchymal renal failure, such as poststreptococcal glomerulonephritis, subacute bacterial endocarditis, or vasculitis. The patient recovered completely with antibiotic therapy, and renal function returned to normal within two weeks. An immunologic mechanism involving E coli was considered responsible for the acute renal failure.
一名患有大肠杆菌败血症的成年患者发生了急性肾内衰竭。临床病程中未出现急性肾衰竭并发革兰氏阴性菌败血症时通常出现的任何情况。肾活检显示急性增生性肾小球肾炎。没有证据支持急性实质性肾衰竭的其他已知病因，如链球菌感染后肾小球肾炎、亚急性细菌性心内膜炎或血管炎。患者通过抗生素治疗完全康复，肾功能在两周内恢复正常。一种涉及大肠杆菌的免疫机制被认为是急性肾衰竭的病因。
