一名糖尿病患者患有长期的高氨血症,原因是尿路感染,由尿素产生细菌引起
Saori Inoue1, Hiroko Yasuda1, Kaoru Yoshida1
1Meitetsu Hospital, Japan.
Internal medicine (Tokyo, Japan)
|November 5, 2023
概括
在阻塞性炎症中产生尿素的细菌可以导致高氨血. 用双J导管和抗生素迅速治疗改善了氨水平和意识,但最终需要进行切除术.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 传染性疾病 传染性疾病
- 胃肠病学 胃肠病学
背景情况:
- 由尿酶产生细菌引起的阻塞性尿路感染可能导致严重的并发症.
- 血中氨含量升高的超氨血症 (hyperammonemia) 可能是这种感染的结果,特别是在患有肝脏疾病的患者中.
研究的目的:
- 报告一种由尿素酶产生细菌引起的阻塞性肌炎病例,导致高氨血.
- 突出这一罕见并发症的临床表现,诊断结果和管理.
主要方法:
- 一个73岁的妇女糖尿病和肝硬化呈现阻塞性肺炎的案例研究.
- 诊断工作包括对氨水平和尿液/血液培养物的血液检测.
- 治疗涉及双J (WJ) 导管插入,抗菌剂,并最终进行切除术.
主要成果:
- 由于Proteus mirabilis感染,该患者患有高氨血症 (140μg/dL).
- 最初用双J导管和抗生素治疗导致氨水平降低和意识改善.
- 持续的围性尿液溢出需要进行切除术.
结论:
- 在阻塞性炎症中产生尿素的细菌对高氨血的风险很大,即使在补偿性肝病患者中也是如此.
- 多面性治疗方法至关重要,但可能并不总是防止需要手术干预,如切除术.
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