Alexandre Susana M D, Matos Carolina O C C, Fortunato Fabiana C F, Sandes Ana R M C
Serviço de Pediatria - Centro Hospitalar do Oeste, Caldas da Rainha, Portugal.
Unidade de Nefrologia e Transplantação Renal Pediátrica, Departamento de Pediatria, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
Case Rep Perinat Med. 2022 Dec 30;12(1):20220018. doi: 10.1515/crpm-2022-0018. eCollection 2023 Jan.
Gross hematuria is rare in the neonate and requires prompt etiology evaluation and intervention. This article aims to draw attention to adenovirus as a cause of hematuria in newborns.
We present the case of a newborn admitted to the neonatal unit after birth with respiratory distress. Empiric treatment with ampicillin and gentamicin was initiated. He presented a favorable clinical and laboratory course with decreasing inflammatory parameters. On day 7 gross hematuria was detected and the urinalysis revealed red blood cells, trace of proteins and leukocytes. Cefotaxime was added after urine and blood cultures. Doppler ultrasound showed bladder sediment with no signs of renal venous thrombosis and the cultures were negative. There was a progressive improvement of gross hematuria with resolution on day 16. Urine adenovirus PCR was positive and the diagnosis of adenovirus hemorrhagic cystitis was made.
Adenovirus should be considered as a potential etiology if clinical symptoms and urinalysis are suggestive of infection, but the urine culture is negative and ensuring that all other possible causes of hematuria are ruled of. As far as the authors know, this is the first case report of a newborn with adenovirus hemorrhagic cystitis.
肉眼血尿在新生儿中罕见，需要迅速进行病因评估和干预。本文旨在引起对腺病毒作为新生儿血尿病因的关注。
我们报告一例新生儿出生后因呼吸窘迫入住新生儿病房。开始使用氨苄西林和庆大霉素进行经验性治疗。随着炎症指标下降，他呈现出良好的临床和实验室进程。在第7天检测到肉眼血尿，尿液分析显示有红细胞、微量蛋白质和白细胞。在进行尿液和血液培养后加用头孢噻肟。多普勒超声显示膀胱有沉积物，无肾静脉血栓形成迹象，培养结果为阴性。肉眼血尿逐渐改善，在第16天消失。尿液腺病毒聚合酶链反应呈阳性，诊断为腺病毒出血性膀胱炎。
如果临床症状和尿液分析提示感染，但尿液培养为阴性且排除了所有其他可能的血尿原因，则应将腺病毒视为潜在病因。据作者所知，这是首例新生儿腺病毒出血性膀胱炎的病例报告。
