Korean Journal of Nephrology 1994;13(3):681-686.
급성 신부전이 동반된 RicRettsia tsutsugamushi 1예
권민중 , 노광식 , 김병길 , 임현이 , 최인준
Abstract
Tsutusgamushi disease is one of the most common febrile illness caused by Rickettsia tsctsumushi in Korea. It is common in adult, but rare in children. In the majority of cases there are no clinical renal mani- festations execpt for mild urinary sediment changes. A 5 year-old-girl was admitted because of fever, vomiting, abdominal pain, and oliguria. On physical examination there were no skin rash of eschar, and no palpable lymph nodes. Laboratory findings showed leukocytosis with shift to left and mild anemia. BUN and creatinine were markedly elevated. Acute peritoneal dialysis was performed because anuria persisted in spite of vigrous hydration and diuretic treatment. Rickettsia tsutsugamushi infection was confirmed by hemagglutination test. Renal biopsy was performed under the guide of ultrasonography after improvement of renal function. Renal pathology was consistent with acute interstitial nephritis. Diffuse interstitial edema and multifocal patch cellular infiltra- tion were observed in the cortex. There was also periglomerular and perivenular infiltration, mostl com- posed by mononuclear and plalsma cells. The glomeruli and tubules showed no obvious changes. The patient recovered completely without any sequelae. Acute renal failure due to Rickettsia tswtsugamushI In children is extremely rare. We report a case of success- fully treated patient with peritoneal dialysis of acute renal failure due to Rickettsia tsutsugamushi as a first case in Korea.
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