Shaked Y, Shpilberg O, Samra Y
Rusinow Department of Internal Medicine C, Beilinson Medical Center, Petah Tiqva, Israel.
Q J Med. 1994 Feb;87(2):103-7.
We reviewed 58 patients, 27 with murine typhus (MT) and 31 with Israeli Mediterranean spotted fever (IMSF), hospitalized at the Sheba Medical Center 1979-1988. Five patients with MT and five with IMSF had evidence of renal impairment. One patient with MT underwent a renal biopsy, and two patients with IMSF died and had autopsy examinations with histology of the kidney. The principal histopathological lesion found in those most severe cases of rickettsiosis-induced renal failure was multifocal perivascular interstitial nephritis. In contrast with previous reports, involvement of the kidneys in rickettsial infection seems to be relatively common. Early diagnosis and treatment with hydration and specific antimicrobial agents is mandatory to prevent morbidity.
我们回顾了1979年至1988年在舍巴医疗中心住院的58例患者，其中27例患鼠型斑疹伤寒（MT），31例患以色列地中海斑疹热（IMSF）。5例MT患者和5例IMSF患者有肾功能损害的证据。1例MT患者接受了肾活检，2例IMSF患者死亡并进行了尸检及肾脏组织学检查。在那些最严重的立克次体病引起的肾衰竭病例中发现的主要组织病理学病变是多灶性血管周围间质性肾炎。与先前的报告相反，立克次体感染累及肾脏似乎相对常见。早期诊断并采用补液及特效抗菌药物治疗对于预防发病至关重要。
