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タイトル: | 細菌性眼内炎を合併した気腫性腎盂腎炎に対し集学的治療で腎が温存された1例 |
その他のタイトル: | A Case of Emphysematous Pyelonephritis Complicated by Bacterial Endophthalmitis in which Multidisciplinary Therapy Led to Preservation of the Kidney |
著者: | 五十嵐, 篤 荒木, 博賢 内田, 稔大 宮﨑, 有 三品, 睦輝 森, 雄貴 喜多, 美穂里 奥野, 博 |
著者名の別形: | Igarashi, Atsushi Araki, Hiromasa Uchida, Toshihiro Miyazaki, Yu Mishina, Mutsuki Mori, Yuki Kita, Mihori Okuno, Hiroshi |
キーワード: | Emphysematous pyelonephritis ECIRS (endoscopic combined intrarenal surgery) Bacterial endophthalmitis |
発行日: | 30-Nov-2020 |
出版者: | 泌尿器科紀要刊行会 |
誌名: | 泌尿器科紀要 |
巻: | 66 |
号: | 11 |
開始ページ: | 387 |
終了ページ: | 392 |
抄録: | A 49-year-old male with untreated diabetes mellitus type 2 experienced eyesight deterioration and general malaise, and was treated for uveitis and orbital cellulitis. Later, he was taken to a local hospital via ambulance for a consciousness disorder and was diagnosed with bilateral infectious endophthalmitis, a right ureteral stone, and emphysematous pyelonephritis. He was then referred to our hospital for further examination and treatment. We immediately initiated intravenous antibiotic therapy with meropenem and glycemic control with continuous subcutaneous insulin infusion, and placed a ureteral and percutaneous drain tube into the right ureter and the emphysema, respectively. We performed a diagnostic and therapeutic vitrectomy on the patient's left eye. Urinary, blood, and vitreous cultures were positive for Klebsiella aerogenes. Abdominal contrast-enhanced computed tomography showed bilaterally comparable renal contrast enhancement. On the 60th hospital day, we performed endoscopic combined intrarenal surgery (ECIRS) and completely removed the urinary stone. Although he lost light sensitivity in his right eye, his left eyesight improved, and his blood glucose level was adequately managed by oral medication. Three months after the surgery, he was discharged from our hospital and he showed no sign of recurrence of the infection at ten months after surgery. |
著作権等: | 許諾条件により本文は2021/12/01に公開 |
DOI: | 10.14989/ActaUrolJap_66_11_387 |
URI: | http://hdl.handle.net/2433/259382 |
PubMed ID: | 33271655 |
出現コレクション: | Vol.66 No.11 |
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