LaMonica C R, Blackston M, Dawson R B, Cowley R A
Adv Shock Res. 1981;6:75-9.
Gram-negative sepsis is a recognized cause of thrombocytopenia and has recently been associated with acute renal failure from acute glomerulonephritis. We report here a patient in which the development of and treatment for trauma, gram-negative sepsis, was followed one day later by rapidly rising WBC (20,000-65,000), creatinine, BUN, and thrombocytopenia (300,000-25,000). Peak creatinine (6.5 mg%) and BUN (160 mg%) levels occurred on the third day of septicemia, when dialysis was begun. During the profound thrombocytopenia (less than 20,000 on days three through five of the septicemia) platelet transfusions did not raise the platelet count. The platelets returned to above 100,000 by day seven of the septicemia and the WBC was under 30,000 by this time. We propose that septicemia caused by E. coli (and staph) was responsible for the concomitant appearance of both thrombocytopenia and acute renal failure in a 20-year-old man.
革兰氏阴性菌败血症是血小板减少症的一个公认病因，最近还与急性肾小球肾炎导致的急性肾衰竭有关。我们在此报告一名患者，该患者因创伤发生革兰氏阴性菌败血症，一天后白细胞（20,000 - 65,000）、肌酐、血尿素氮迅速升高，血小板减少（300,000 - 25,000）。败血症第三天肌酐峰值（6.5mg%）和血尿素氮峰值（160mg%）出现，此时开始透析。在严重血小板减少期间（败血症第三天至第五天血小板计数低于20,000），输注血小板并未提高血小板计数。败血症第七天血小板计数恢复到100,000以上，此时白细胞计数低于30,000。我们认为，一名20岁男性同时出现血小板减少症和急性肾衰竭是由大肠杆菌（和葡萄球菌）引起的败血症所致。
