당뇨병성 혈액투석 환자에서 우연히 발견된 무증상 기종성 신우신염
Asymptomatic Emphysematous Pyelonephritis Incidentally Detected with Computed Tomography in a Diabetic Hemodialysis Patient
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초록
기종성 신우신염은 신 실질에 공기 음영을 동반하는 급성괴사성 감염 질환으로 혈액투석 환자에서는 매우 드물게 발생한다. 대개 고열 등의 임상 증세가 뚜렷하게 나타나고 임상 경과가 빠르고 예후가 좋지 않아 즉각적인 치료가 필요한질환이나 본 증례와 같이 무증상으로 발현하는 경우가 있어진단과 치료가 지연될 수 있으므로 주의를 요한다. 저자들은혈액투석 환자에서 우연히 발견된 무증상의 기종성 신우신염을 확인하고 항생제 치료로 호전된 증례를 경험하였기에경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Emphysematous pyelonephritis (EPN) is a necrotizing infection of the kidney with gas formation that can be fatal if it is not detected and treated promptly. Typical manifestations are high fever, flank pain, and shock. It typically occurs in patients with diabetes and, although rarely reported, in hemodialysis (HD) patients with or without diabetes. Furthermore, asymptomatic EPN has not yet been reported in HD patients. Here, we report a case of asymptomatic EPN in a diabetic HD patient incidentally detected with follow-up abdominal computed tomography after resection of colon cancer. (Korean J Med 2016;91:202-205
참고문헌 (10)
- Chae BG, "A case of left emphysematous pyelonephritis in a diabetic end-stage renal disease patient undergoing hemodialysis therapy", The Chonbuk University Medical Journal, 37, pp.61~66 (2013)
- Su CY, "Successful treatment of bilateral emphysematous pyelonephritis in a uremic patient without nephrectomy", Ren Fail, 31, pp.167~170 (2009)
- Yeh CL, "Bilateral emphysematous pyelonephritis and cystitis in an ESRD patient presenting with septic shock", Acta Clin Belg, 64, pp.160~161 (2009)
- Vlachopanos G, "Successful medical treatment of emphysematous pyelonephritis in chronic hemodialysis", Hemodial Int, 19, pp.54~58 (2015)
- Suzuki R, "Successful management of bilateral emphysematous pyelonephritis with abscess formation in a chronic hemodialysis patient : a case report", CEN Case Reports, 4, pp.90~94 (2015)
- Hamouda M, "Emphysematous pyelonephritis in a diabetic patient on maintenance hemodialysis : a case report", Arab J Nephrol Transplant, 7, pp.109~111 (2014)
- Ng TM, "Empiric piperacillin-tazobactam versus carbapenems in the treatment of bacteraemia due to extended-spectrum beta-lactamase-producing enterobacteriaceae", PLoS One, 11, pp.0153696~ (2016)
- 이현정, "우연히 발견된 무증상 기종성 신우신염 1예", 대한내과학회지, 89(5), pp.567~570 (2015), 대한내과학회[DOI]
- Cho BS, "A case of emphysematous pyelonephritis in diabetes mellitus with asymptomatic bacteriuria", Journal of Korean diabetes, 2, pp.170~175 (2000)
- Swami YK, "Incidentally detected emphysematous pyelonephritis", Cent European J Urol, 65, pp.53~54 (2012)