Chisavu Flavia, Gafencu Mihai, Steflea Ruxandra Maria, Vaduva Adrian, Izvernariu Floriana, Stroescu Ramona Florina
4th Pediatric Clinic, "Louis Turcanu" Children's Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timisoara, Romania.
Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine "Victor Babes", "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Children (Basel). 2024 Aug 14;11(8):981. doi: 10.3390/children11080981.
Scabies is a parasitic infestation of the skin with high prevalence in crowded spaces. In some instances, scabies becomes the underlying factor for complicated skin-borne opportunistic pathogens infections in both children and adults. Geographic area and socio-economic factors are determinants of the endemic pattern of this disease. Currently, the treatment of scabies has been under special attention. A combination of oral therapy with Ivermectin and sulfur-based ointments are the gold standard. However, caution is required in patients with kidney impairment. The renal involvement in children with scabies is mainly caused by acute glomerulonephritis. The severity of the nephritic syndrome can lead to other complications. Also, Ivermectin possesses a nephrotoxic effect. Severe hypertension can lead to neurological complications. The aim of our case report is to present two unusual complications in brothers with scabies. We report the cases of two brothers with scabies who presented with severe skin infection that developed acute post infectious glomerulonephritis (APIGN). In addition, one of the brothers presented with posterior reversible encephalopathy syndrome (PRES). The other one developed acute tubule-interstitial acute kidney injury following Ivermectin administration. The evolution of skin lesions was favorable, and kidney function returned to normal in both brothers.
疥疮是一种在拥挤空间中高发的皮肤寄生虫感染。在某些情况下,疥疮成为儿童和成人皮肤传播的机会性病原菌复杂感染的潜在因素。地理区域和社会经济因素是这种疾病流行模式的决定因素。目前,疥疮的治疗受到特别关注。伊维菌素口服疗法与硫磺基软膏联合使用是金标准。然而,肾功能损害患者需要谨慎使用。疥疮患儿的肾脏受累主要由急性肾小球肾炎引起。肾病综合征的严重程度可导致其他并发症。此外,伊维菌素具有肾毒性作用。严重高血压可导致神经并发症。我们病例报告的目的是介绍两例患疥疮兄弟出现的不寻常并发症。我们报告了两例患疥疮的兄弟病例,他们出现严重皮肤感染并发展为急性感染后肾小球肾炎(APIGN)。此外,其中一名兄弟出现了后部可逆性脑病综合征(PRES)。另一名兄弟在服用伊维菌素后发生了急性肾小管间质性急性肾损伤。两兄弟的皮肤病变演变良好,肾功能均恢复正常。