Domingue G J, Woody H B, Farris K B, Schlegel J U
Arch Intern Med. 1979 Dec;139(12):1355-60.
Casts with numerous and unusually large granules were seen in the urine of a child with renal Fanconi's syndrome. When the urine sediment was sealed under a coverslip for several days, many granules changed to filamentous bacterial variants that segmented and, finally, appeared as streptococcal-like forms. When the patient's blood was cultured by a special method, bacterial variants grew consistently, and frequently reverted to parent coccal forms, although conventional cultures were negative. Variants from blood cultures had the same morphology and staining properties as granules in casts and in cystic structures found within hypertrophied renal pelvic epithelial cells. Cryptic parasitization with bacterial variants probably occurs in many nephropathies. Variants are known to produce toxins and immunogens, which could lead to mesangial and basement membrane deposits as well as to occlusive reactions in the renal microcirculation.
在一名患有肾范科尼综合征的儿童尿液中发现了含有大量且异常大颗粒的管型。当尿液沉淀物在盖玻片下密封数天后，许多颗粒转变为丝状细菌变体，这些变体发生分裂，最终呈现出链球菌样形态。当用一种特殊方法培养该患者的血液时，细菌变体持续生长，并且尽管传统培养为阴性，但它们经常回复为亲代球菌形态。血液培养中的变体与管型以及肥大肾盂上皮细胞内囊性结构中的颗粒具有相同的形态和染色特性。隐匿性细菌变体寄生可能在许多肾病中发生。已知变体可产生毒素和免疫原，这可能导致系膜和基底膜沉积以及肾微循环中的闭塞反应。
