Korman T M, Spelman D W, Perry G J, Dowling J P
Department of Microbiology and Infectious Diseases, Alfred Hospital, Inner and Eastern Health Care Network, Melbourne, Victoria, Australia.
Clin Infect Dis. 1998 Feb;26(2):359-64. doi: 10.1086/516308.
We report a case of acute glomerulonephritis associated with acute Q fever. An abattoir worker with a nonspecific febrile illness and pneumonia and abnormal liver function test results developed hematuria, proteinuria, and acute renal failure that resolved with appropriate antimicrobial therapy. Renal biopsy demonstrated diffuse proliferative and exudative glomerulonephritis. Serological tests confirmed recent infection with Coxiella burnetii, with a fourfold rise in the titer of phase II antibody, positive phase II IgM antibody, and negative phase I antibody. Other known causes of glomerulonephritis were excluded. Most reports of renal complications of C. burnetii infection describe glomerulonephritis associated with endocarditis due to chronic Q fever. Renal involvement in patients with acute C. burnetii infection has been rarely described. Glomerulonephritis should be recognized as a complication of acute C. burnetii infection and endocarditis due to chronic Q fever.
我们报告一例与急性Q热相关的急性肾小球肾炎病例。一名屠宰场工人出现非特异性发热性疾病、肺炎及肝功能检查结果异常，随后发展为血尿、蛋白尿和急性肾衰竭，经适当的抗菌治疗后病情缓解。肾活检显示为弥漫性增殖性和渗出性肾小球肾炎。血清学检测证实近期感染了伯氏考克斯体，II期抗体滴度呈四倍升高，II期IgM抗体阳性，I期抗体阴性。排除了其他已知的肾小球肾炎病因。大多数关于伯氏考克斯体感染肾脏并发症的报告描述的是与慢性Q热所致心内膜炎相关的肾小球肾炎。急性伯氏考克斯体感染患者的肾脏受累情况鲜有报道。肾小球肾炎应被视为急性伯氏考克斯体感染和慢性Q热所致心内膜炎的一种并发症。
