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一例由肺炎克雷伯菌引起的肾盂肾炎导致的温德利希综合征病例。

A Case of Wunderlich Syndrome Caused by Pyelonephritis Due to Klebsiella pneumoniae.

作者信息

Itagaki Hideya, Hagino Takuro, Suzuki Katuhiko

机构信息

Department of Emergency and Disaster Medicine, Tohoku Medical and Pharmaceutical University Hospital, Miyagi, JPN.

Department of Neurology, Tohoku Medical and Pharmaceutical University Hospital, Sendai, JPN.

出版信息

Cureus. 2024 Sep 24;16(9):e70131. doi: 10.7759/cureus.70131. eCollection 2024 Sep.

Abstract

Wunderlich syndrome, characterized by spontaneous nontraumatic renal hemorrhage, is a rare but severe condition often presenting with Lenk's triad: acute abdominal pain, flank mass, and hypovolemic shock. While typically caused by neoplastic or vascular conditions, infection-induced Wunderlich syndrome is uncommon. This case report details an 80-year-old woman who developed Wunderlich syndrome secondary to pyelonephritis caused by . The patient presented with septic shock and was diagnosed with left subcapsular renal haematoma. Despite initial antimicrobial therapy, the patient's condition deteriorated, requiring surgical drainage. This case emphasizes the importance of considering surgical intervention in addition to antimicrobial treatment in managing Wunderlich syndrome, especially in patients with pre-existing conditions like diabetes mellitus, which increases the risk of severe complications.

摘要

温德利希综合征以自发性非创伤性肾出血为特征,是一种罕见但严重的病症,常表现为伦克三联征:急性腹痛、胁腹肿块和低血容量性休克。虽然通常由肿瘤或血管疾病引起,但感染诱发的温德利希综合征并不常见。本病例报告详细介绍了一名80岁女性,她因[此处原文缺失病因]引起的肾盂肾炎继发温德利希综合征。患者出现感染性休克,被诊断为左肾包膜下血肿。尽管最初进行了抗菌治疗,但患者病情恶化,需要手术引流。本病例强调了在治疗温德利希综合征时,除抗菌治疗外考虑手术干预的重要性,尤其是对于患有糖尿病等基础疾病的患者,这类疾病会增加严重并发症的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0390/11502730/7112c333aa8b/cureus-0016-00000070131-i01.jpg

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