Xie Meng, Hong Angelina, Gupta Mayuri, Dragovic Dusan
Department of Internal Medicine, HCA Florida Northwest Hospital, USA.
Department of Gastroenterology, HCA Florida Northwest Hospital, USA.
J Community Hosp Intern Med Perspect. 2024 Sep 9;14(5):110-113. doi: 10.55729/2000-9666.1387. eCollection 2024.
Cholera is an acute gastroenteritis that can lead to fatal dehydration and metabolic derangements. Cases of cholera in the United States are typically associated with international travel. Patients who are persistently dehydrated despite aggressive rehydration and antibiotic therapy may require hemodialysis until symptom resolution and stabilization of renal function. We present a case of a 47-year-old male who recently returned from a trip to Haiti and presented with intractable abdominal pain, nausea, vomiting, and watery diarrhea. He was found to be in acute renal failure with a high anion gap metabolic acidosis of an unclear etiology. Abdominal imaging was consistent with enterocolitis, and his stool culture grew . In addition to aggressive fluid resuscitation, he underwent two intermittent hemodialysis sessions and received sodium bicarbonate and antibiotic therapy. Renal function normalized by hospital day 6. This is a novel case of severe renal failure and high anion gap metabolic acidosis in a US patient with cholera; our review of the literature did not find any case reports regarding cholera in the past decade involving a US citizen.
霍乱是一种急性肠胃炎，可导致致命的脱水和代谢紊乱。美国的霍乱病例通常与国际旅行有关。尽管进行了积极的补液和抗生素治疗，但仍持续脱水的患者可能需要进行血液透析，直到症状缓解且肾功能稳定。我们报告一例47岁男性病例，他最近从海地旅行归来，出现顽固性腹痛、恶心、呕吐和水样腹泻。他被发现患有急性肾衰竭，伴有病因不明的高阴离子间隙代谢性酸中毒。腹部影像学检查结果与小肠结肠炎相符，其粪便培养结果为……除了积极的液体复苏外，他还接受了两次间歇性血液透析治疗，并接受了碳酸氢钠和抗生素治疗。到住院第6天时，肾功能恢复正常。这是一例美国霍乱患者出现严重肾衰竭和高阴离子间隙代谢性酸中毒的新病例；我们对文献的回顾未发现过去十年中有任何关于涉及美国公民霍乱的病例报告。
