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社区获得性肺炎合并急性肾损伤并发横纹肌溶解症——资源有限环境下的一例具有挑战性的病例报告

Community-Acquired Pneumonia with Acute Kidney Injury Complicated by Rhabdomyolysis- A Challenging Case Report in Resource Limit Setting.

作者信息

Mohamed Ibrahim Abdullahi, Omar Abdullahi Abdirahman, Hassan Mohamed Abdulahi, Badawi Omar Hassan

机构信息

Department of Internal Medicine and Intensive Care Unit, Dr. Sumait Hospitals, Faculty Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia.

Department of Radiology, Dr. Sumait Hospital, Faculty Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia.

出版信息

Int Med Case Rep J. 2024 Nov 1;17:895-901. doi: 10.2147/IMCRJ.S492874. eCollection 2024.


DOI:10.2147/IMCRJ.S492874
PMID:39502308
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11537182/
Abstract

BACKGROUND: Community-acquired pneumonia (CAP) is a common infectious disease that can lead to complications such as rhabdomyolysis (RM), a rare but potentially life-threatening condition involving muscle breakdown. RM can further complicate the clinical course by causing acute kidney injury (AKI). We present a case of Community-acquired pneumonia with AKI complicated by rhabdomyolysis in a resource-limited setting. CASE PRESENTATION: A 67-year-old male presented with high fever, cough, and shortness of breath. He had no significant medical history. On examination, he was febrile, tachypneic, and tachycardic, with right-sided lung crackles. Lab tests showed elevated inflammatory markers and impaired kidney function. Chest radiography revealed right upper lobe consolidation, confirming pneumonia and AKI. He was treated with fluids, antibiotics, and supportive care, but his condition worsened, requiring intensive care unit (ICU). In the ICU, dark urine and elevated creatine kinase confirmed rhabdomyolysis. After aggressive fluid therapy and antibiotics the patient improved over six days and was transferred to the ward. By day 10, he fully recovered and was discharged with follow-up. CONCLUSION: This case underscores the importance of early recognition and prompt management of CAP complicated by AKI and rhabdomyolysis, even in resource-limited settings. Timely intervention can lead to favorable outcomes despite challenges.

摘要

背景:社区获得性肺炎(CAP)是一种常见的传染病,可导致诸如横纹肌溶解症(RM)等并发症,这是一种罕见但可能危及生命的涉及肌肉分解的病症。横纹肌溶解症可通过引起急性肾损伤(AKI)使临床病程进一步复杂化。我们报告一例在资源有限环境下发生的社区获得性肺炎合并急性肾损伤并伴有横纹肌溶解症的病例。 病例介绍:一名67岁男性出现高热、咳嗽和呼吸急促。他没有显著的病史。检查时,他发热、呼吸急促且心动过速,右侧肺部有啰音。实验室检查显示炎症标志物升高且肾功能受损。胸部X线检查显示右上叶实变,确诊为肺炎和急性肾损伤。他接受了补液、抗生素治疗及支持治疗,但病情恶化,需要入住重症监护病房(ICU)。在ICU中,深色尿液和肌酸激酶升高证实了横纹肌溶解症。经过积极的补液治疗和使用抗生素后,患者在六天内病情好转并转至病房。到第10天,他完全康复并出院随访。 结论:本病例强调了即使在资源有限的环境下,早期识别和及时处理合并急性肾损伤和横纹肌溶解症的社区获得性肺炎的重要性。尽管存在挑战,但及时干预可带来良好的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eca7/11537182/99fdc6f65111/IMCRJ-17-895-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eca7/11537182/b785c7c83ef2/IMCRJ-17-895-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eca7/11537182/99fdc6f65111/IMCRJ-17-895-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eca7/11537182/b785c7c83ef2/IMCRJ-17-895-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eca7/11537182/99fdc6f65111/IMCRJ-17-895-g0002.jpg

相似文献

[1]
Community-Acquired Pneumonia with Acute Kidney Injury Complicated by Rhabdomyolysis- A Challenging Case Report in Resource Limit Setting.

Int Med Case Rep J. 2024-11-1

[2]
[Children with parainfluenza pneumonia complicated with rhabdomyolysis syndrome and acute kidney injury: a case report and literature review].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2020-7

[3]
Extremely elevated creatine kinase associated with rhabdomyolysis-induced acute kidney injury in a patient with Huntington's disease: a case report.

J Med Case Rep. 2023-7-10

[4]
Exceptionally High Creatine Kinase (CK) Levels in Multicausal and Complicated Rhabdomyolysis: A Case Report.

Am J Case Rep. 2017-7-4

[5]
Legionnaires' Disease Complicated with Rhabdomyolysis and Acute Kidney Injury.

Eur J Case Rep Intern Med. 2023-7-10

[6]
Legionnaires' Disease Complicated with Rhabdomyolysis and Acute Kidney Injury in an AIDS Patient.

Case Rep Infect Dis. 2017

[7]
The Triad of Legionnaires' Disease, Rhabdomyolysis, and Acute Kidney Injury: A Case Report.

Am J Case Rep. 2022-6-3

[8]
Rhabdomyolysis with compartment syndrome-induced acute kidney injury in resource-limited settings: A case report.

Caspian J Intern Med. 2022

[9]
A Case of Legionella Pneumonia with Rhabdomyolysis, with Extremely high Creatinine Kinase without Acute Kidney Injury in an Adult.

Eur J Case Rep Intern Med. 2024-7-4

[10]
Legionella-Induced Rhabdomyolysis and Acute Kidney Injury: A Case Report.

Cureus. 2024-6-10

本文引用的文献

[1]
A Lethal Combination: Legionnaires' Disease Complicated by Rhabdomyolysis, Acute Kidney Injury, and Non-Occlusive Mesenteric Ischemia.

Am J Case Rep. 2023-9-24

[2]
Legionella pneumonia complicated with rhabdomyolysis and acute kidney injury diagnosed by metagenomic next-generation sequencing: a case report.

World J Emerg Med. 2023

[3]
Legionella associated rhabdomyolysis: a case report.

J Med Case Rep. 2023-6-22

[4]
Metagenomic next-generation sequencing confirms the diagnosis of pneumonia with rhabdomyolysis and acute kidney injury in a limited resource area: a case report and review.

Front Public Health. 2023

[5]
The Triad of Legionnaires' Disease, Rhabdomyolysis, and Acute Kidney Injury: A Case Report.

Am J Case Rep. 2022-6-3

[6]
Rhabdomyolysis: an American Association for the Surgery of Trauma Critical Care Committee Clinical Consensus Document.

Trauma Surg Acute Care Open. 2022-1-27

[7]
Community-acquired pneumonia complicated by rhabdomyolysis: A clinical analysis of 11 cases.

World J Clin Cases. 2019-12-26

[8]
Evaluation and Treatment of Severe Rhabdomyolysis in a Patient with Legionnaires' Disease.

Cureus. 2019-9-26

[9]
Established association of legionella with rhabdomyolysis and renal failure: A review of the literature.

Respir Med Case Rep. 2019-10-28

[10]
Comparative efficacy of Chinese herbal injections for the treatment of community-acquired pneumonia: A Bayesian network meta-analysis of randomized controlled trials.

Phytomedicine. 2019-7-2

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