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首例由脱硫弧菌引起的肾囊肿感染:病例报告及文献复习。

First case of a renal cyst infection caused by Desulfovibrio: a case report and literature review.

机构信息

Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 1628666, Japan.

Department of Infectious Diseases, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 1628666, Japan.

出版信息

BMC Nephrol. 2022 May 23;23(1):194. doi: 10.1186/s12882-022-02803-w.

Abstract

BACKGROUND

Genus Desulfovibrio species is a sulphate-reducing anaerobic gram-negative rod that resides in the human oral cavity and intestinal tract. It was reported as the causative pathogen of bacteraemia and abdominal infections, but not renal cyst infection, and Desulfovibrio fairfieldensis has higher pathogenicity than other Desulfovibrio species.

CASE PRESENTATION

A 63-year-old man was on haemodialysis for end-stage renal failure due to autosomal dominant polycystic kidney disease. On admission, he had a persistent high-grade fever, right lumbar back pain, and elevated C-reactive protein levels. His blood and urine cultures were negative. He received ciprofloxacin and meropenem; however, there was no clinical improvement. Contrast-enhanced computed tomography and plain magnetic resonance imaging revealed a haemorrhagic cyst at the upper pole of the right kidney. The lesion was drained. Although the drainage fluid culture was negative, D. fairfieldensis was detected in a renal cyst using a polymerase chain reaction. After the renal cyst drainage, he was treated with oral metronidazole and improved without any relapse.

CONCLUSIONS

To the best of our knowledge, this is the first reported case of a renal cyst infection with Desulfovibrio species. D. fairfieldensis is difficult to detect, and polymerase chain reaction tests can detect this bacterium and ensure better management for a successful recovery.

摘要

背景

脱硫弧菌属是一种居住在人类口腔和肠道中的硫酸盐还原厌氧革兰氏阴性杆菌。它曾被报道为菌血症和腹部感染的病原体,但不是肾囊肿感染的病原体,而且与其他脱硫弧菌属相比,费尔菲尔德脱硫弧菌具有更高的致病性。

病例介绍

一名 63 岁男性因常染色体显性多囊肾病导致终末期肾衰竭而接受血液透析。入院时,他持续高热,右侧腰背部疼痛,C 反应蛋白水平升高。他的血液和尿液培养均为阴性。他接受了环丙沙星和美罗培南治疗,但临床症状没有改善。增强 CT 和磁共振成像显示右肾上极有一个出血性囊肿。对病变进行了引流。尽管引流液培养为阴性,但聚合酶链反应检测到肾囊肿中存在费尔菲尔德脱硫弧菌。肾囊肿引流后,他口服甲硝唑治疗,病情好转,无复发。

结论

据我们所知,这是首例报道的脱硫弧菌属肾囊肿感染病例。费尔菲尔德脱硫弧菌难以检测,聚合酶链反应检测可检测到该细菌,有助于更好地管理,从而实现成功康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0505/9125926/f42d1938941d/12882_2022_2803_Fig1_HTML.jpg

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