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Title: ウレアーゼ産生菌による尿路感染に伴う高アンモニア血症から意識障害を発症した1例
Other Titles: A Case of Hyperammonemia Caused by Urinary Tract Infection Due to Urease-Producing Bacteria
Authors: 江村, 正博  KAKEN_name
土橋, 一成  KAKEN_name
清水, 洋祐  KAKEN_name
金丸, 聰淳  KAKEN_name
的場, 俊  KAKEN_name
伊藤, 哲之  KAKEN_name
Author's alias: Emura, Masahiro
Tsuchihashi, Kazunari
Shimizu, Yosuke
Kanamaru, Sojun
Matoba, Shun
Ito, Noriyuki
Keywords: Hyperammonemia
Urease-producing bacteria
Urinary tract infection
Issue Date: 31-Aug-2016
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要 = Acta urologica Japonica
Volume: 62
Issue: 8
Start page: 421
End page: 425
Abstract: We present here a rare case of hyperammonemia without liver dysfunction or portal-systemic shunting. The patient was an 80-year-old woman with a history of neurogenic bladder. She was admitted to a nearby hospital for vomiting, diarrhea and consciousness disturbance. Two days after admission, she was transferred to our hospital because of persistant consciousness disturbance. Laboratory data revealed hyperammonemia, but there was no indication of liver dysfunction. Moreover abdominal computed tomography did not reveal any clear finding of liver disease or portal-systemic shunting, but we noted multiple large bladder diverticula. Antibiotic therapy, tracheal intubation, ventilator management and bladder catheterization were performed. The patient’s level of consciousness improved rapidly. Urinary culture revealed Bacteroides ureolyticus (urease-producing bacteria). The patient was diagnosed with hyperammonemia and a urinary tract infection due to urease-producing bacteria. Thus, physicians should be aware that obstructive urinary tract infections due to urease-producing bacteria can also be the cause of hyperammonemia.
Rights: 許諾条件により本文は2017/09/01に公開
DOI: 10.14989/ActaUrolJap_62_8_421
PubMed ID: 27624109
Appears in Collections:Vol.62 No.8

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