Development of Hemolytic Uremic Syndrome in Renal Transplant Recipient due to Typhoid Fever: A Case Report and Brief Summary of the Literature

Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Typhoid fever caused by Salmonella typhi, a systemic infectious disease that can affect several organs, is rarely encountered in clinical practice. Due to developments in the food industry, endemic typhoid fever as a result of Salmonella bacteremia has been reduced. However, it can have a high mortality and morbidity if left untreated, especially in high-risk groups. Presently described is the case of a 31-year-old kidney transplant patient who presented with diarrhea, a skin rash, macroscopic hematuria, oliguria, microangiopathic hemolytic anemia, and Salmonella typhi cultivated in blood cultures. To our knowledge, this is the first case of HUS due to typhoid fever in a renal transplant recipient to be reported in the literature.

Transplante Böbrekte Hemolitik Üremik Sendrom Gelişimi: Tifoid Ateş; Olgu Sunumu Nedeniyle Literatürün Gözden Geçirilmesi

Hemolitik üremik sendrom (HÜS) mikroanjiopatik hemolitik anemi, trombositopeni ve akut böbrek hasarı ile karakterize bir sendromdur. Tifoid ateş ise, klinik pratikte nadir görülen fakat birçok organı etkileyebilen Salmonella tifonun sebep olduğu sistemik bir enfeksiyon hastalığıdır. Gıda teknolojisindeki gelişmeler sonucu geçmiş yıllarda görülen endemiler görülmemekle birlikte immünsistemin baskılandığı durumlarda Salmonella bakteriyemisi (tifoid ateş) görülebilmekte ve komplikasyonlara yol açabilmektedir. Tedavisiz kaldığı takdirde özellikle yüksek riskli guruplarda yüksek morbidite ve mortaliteye sebep olabilileceği için dikkate değerdir. Biz burada ishal, idrar miktarında azalma ve vücudunda dökültü şikayetiyle başvuran, makroskopik hematürisi, oligürisi, mikroanjiopatik hemolitik anemisi olan ve kan kültürlerinde Salmonella typhi üremesi olan 31 yaşında böbrek nakilli hasta sunduk. Literatürde transplante böbrekte tifoid ateşe başlı olarak gelişen ilk hemolitik üremik sendrom olgusu olması nedeniyle sunuma layık görüldü.

Kaynakça

1. Fakhouri F, Zuber J, Frémeaux-Bacchi V, Loirat C. Haemolytic uraemic syndrome. Lancet 2017;390:681–96.

2. Parry CM, Hien TT, Daugan G, White NJ, Farrar JJ. Typhoid fever. N Eng J Med,2002;347: 1770–82.

3. Gulati PD, Saxena SN, Gupta PS, Chuttani HK. Changing pattern of typhoid fever. Am J Med 1968;45:544–8.

4. Hayashi M, Kouzu H, Nishihara M, Takahashi T, Furuhashi M, Sakamoto K, et al. Acute renal failure likely due to acute nephritic syndrome associated with typhoid fever. Intern Med 2005;44:1074– 7.

5. Indraprasit S, Boonpucknavig V, Boonpucknavig S. IgA nephropathy associated with enteric fever. Nephron 1985;40:219–22.

6. Baker NM, Millis AE, Rachman I, Thomas JE. Haemolytic-uraemic syndrome in typhoid fever. Br Med J 1974;2:84–7.

7. Youmbissi TJ, Malik TQ, Ajit Kumar S, Rafi A, Al Khursanny AI, Karkar A. Henoch-Schönlein nephritis and salmonella typhi septicaemia. Nephrol Dial Transplant 2001;16:1081–2.

8. Caers J, Peeters P, Vanden Houte K, Sennesael J, Van der Niepen P, Verbeelen D. Acute interstitial nephritis associated with salmonellosis. Eur J Intern Med 2006;17:217–9.

9. Basić-Jukić N, Jurić I, Brunetta-Gavranić B, Kes P, Bubić-Filipi L, Glavas-Boras S. Thrombotic microangiopathy after kidney transplantation [Article in Croatian]. Acta Med Croatica 2008;62 Suppl 1:93–6.

10. Arslan H, Inci EK, Azap OK, Karakayali H, Torgay H, Haberal M. Etiologic agents of diarrhea in solid organ recipients. Transpl Infect Dis 2007;9:270–5.

11. Ejlertsen T, Aunsholt NA. Salmonella bacteremia in renal transplant recipients. Scand J Infect Dis 1989;21:241–4.

12. Parry C, Wain J, Chinh NT, Vinh H, Farrar JJ. Quinolone-resistant Salmonella typhi in Vietnam. Lancet 1998;351:1289

13. Dummar JS. Infections in solid organ transplant recipients. In: Mandell GL, Douglas RG, Mandell, Bennett JE, Dolin R, editors. Douglas, and Bennett’s principles and practice of infectious diseases. Philadelphia : Elsevier Churchill Livingstone; 2005. p. 2646–50.

14. Tena D, González-Praetorius A, Bisquert J. Urinary tract infection due to non-typhoidal Salmonella: report of 19 cases. J Infect 2007;54:245–9.

15. Mathai E, John TJ, Rani M, Mathai D, Chacko N, Nath V, et al. Significance of salmonella typhi bacteriuria. J Clin Microbiol 1995;33:1791–2.

Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

970327

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