Asao K, Utsunomiya Y, Hirano K, Shike T, Imasawa T, Omura K, Tomonari H, Kawamura T, Kuriyama S, Sakai O
Department of Internal Medicine, Tokyo-to Saiseikai Central Hospital.
Intern Med. 1995 Aug;34(8):785-9. doi: 10.2169/internalmedicine.34.785.
A 25-year-old man was admitted with complaints of fever and macrohematuria. Laboratory tests showed a substantial increase in serum creatine phosphokinase and creatinine in association with myoglobinuria and proteinuria. Blood culture grew Streptococcus salivarius and Streptococcus oralis. Findings of renal biopsy were compatible with IgA nephropathy. The glomeruli had a mild mesangial proliferation without crescentic lesions. Changes of the interstitium and tubules were not evident. The clinical course and laboratory results strongly suggested a possible link between Streptococcus salivarius/oralis infection, and rhabdomyolysis. Rhabdomyolysis is rarely seen as a complication of bacterial infection, and the present case emphasizes the importance of suspecting bacteremia due to Streptococcus salivarius/oralis in the presence of rhabdomyolysis.
一名25岁男性因发热和肉眼血尿入院。实验室检查显示血清肌酸磷酸激酶和肌酐显著升高，伴有肌红蛋白尿和蛋白尿。血培养分离出唾液链球菌和口腔链球菌。肾活检结果符合IgA肾病。肾小球有轻度系膜增生，无新月体病变。间质和肾小管的改变不明显。临床病程和实验室结果强烈提示唾液链球菌/口腔链球菌感染与横纹肌溶解之间可能存在联系。横纹肌溶解很少作为细菌感染的并发症出现，本病例强调了在出现横纹肌溶解时怀疑唾液链球菌/口腔链球菌所致菌血症的重要性。
