Kidney allograft pyelonephritis caused by Salmonella enterica serovar Schwarzengrund
| Autor: | Takao Okawa, Noriko Mori, Haruomi Nishio, Ryo Yamada, Yoko Matsuo, Masaaki Murakami, Satoshi Tanaka, Ken Matsuo, Kenta Ito, Takumi Yamamoto, Kiyoshi Mori, Yuji Iwatani |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty Salmonella medicine.drug_class Urinary system 030106 microbiology Antibiotics medicine.disease_cause Gastroenterology Vesicoureteral reflux Immunocompromised Host 03 medical and health sciences Internal medicine medicine Animals Humans Pharmacology (medical) Kidney transplantation Vesico-Ureteral Reflux Pyelonephritis biology business.industry Salmonella enterica Middle Aged Amoxicillin Allografts medicine.disease biology.organism_classification Kidney Transplantation Anti-Bacterial Agents Infectious Diseases Salmonella Infections Urinary Tract Infections Immunology Cats Ceftriaxone Female business medicine.drug |
| Zdroj: | Journal of Infection and Chemotherapy. 23:481-484 |
| ISSN: | 1341-321X |
| Popis: | Kidney transplant recipients (KTRs) taking immunosuppressive drugs have a 20-fold greater risk of nontyphoidal Salmonella (NTS) infection than the healthy adult population. Among KTRs, the urinary tract is the most common site of infection. However, few cases of urinary tract infection caused by NTS have been documented in KTRs, and only one in Japan. Furthermore, it frequently induces acute allograft rejection with high mortality. Salmonella enterica subsp. enterica serovar Schwarzengrund (S. Schwarzengrund) is now among the more common Salmonella serovars isolated in Japan and is likely to be invasive. We present a case of a 45-year old female with vesicoureteral reflux to her transplanted kidney who developed kidney allograft pyelonephritis caused by S. Schwarzengrund. She was admitted to our hospital with fever, urodynia, lower abdominal pain, gross hematuria, and cloudy urine. Urine cultures were positive for S. Schwarzengrund. Exposure to cats, especially stray cats, were identified as the most likely source. We administered antibiotics for 4 weeks (ceftriaxone then amoxicillin, each for 2 weeks) and educated her about pet safety. She experienced no recurrence of infection or clinical kidney allograft rejection for 3 months post-treatment. NTS should be considered as a possible pathogen of urinary tract infection among KTRs, especially in cases with animal exposure or structural urologic abnormalities. When the pathogen is NTS, appropriate antibiotics and treatment periods are essential for preventing recurrence and allograft rejection after the completion of treatment. |
| Databáze: | OpenAIRE |
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