[Thrombotic microangiopathy during urinary tract infection]
G Quattrocchio1, C Rollino, G Beltrame
1Divisione di Nefrologia e Dialisi, Ospedale S G Bosco, Torino-Italy. g.quattrocchio@tin.it
Summary
An elderly woman developed sepsis and acute kidney injury from a urinary tract infection. The infection caused acute tubular necrosis and thrombotic microangiopathy, mimicking hemolytic-uremic syndrome.
Area of Science:
- Nephrology
- Infectious Diseases
- Hematology
Background:
- Sepsis can present with multi-organ dysfunction, including acute kidney injury.
- Urinary tract infections are common causes of sepsis, particularly in elderly patients.
- Thrombotic microangiopathies share clinical features with other acute renal failure causes.
Observation:
- An 84-year-old female presented with sepsis, thrombocytopenia, anemia, and acute renal failure requiring hemodialysis.
- Diagnostic workup revealed a severe Enterococcus faecalis urinary tract infection.
- The clinical presentation complicated differential diagnosis, initially suggesting hemolytic-uremic syndrome.
Findings:
- The Enterococcus faecalis UTI was identified as the cause of mild sepsis.
- The sepsis led to acute tubular necrosis.
- Thrombotic microangiopathy was also observed as a complication.
Implications:
- This case highlights the importance of identifying infectious sources in patients with multi-organ failure.
- Recognizing UTI as a cause of thrombotic microangiopathy is crucial for appropriate management.
- Prompt diagnosis and treatment of sepsis are vital to prevent severe renal complications.
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