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KMID : 0359919940130030681
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Korean Journal of Nephrology
1994 Volume.13 No. 3 p.681 ~ p.686
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Successful Treatment of Acute Renal Failure due to Rickettsia tsutsugamushi
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권민중
노광식/김병길/임현이/최인준
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Abstract
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Tsutusgamushi disease is one of the most common febrile illness caused by Ricrettsia tsutsugamushi in Korea. It is common in adult, but rare in children. In the majority of cases there are no clinicla renal manifestations execpt for mild urinary
sediment changes.
A 5 year-old-girl was admitted because of fever, vomiting, abdominal pain, and oliguria. On physical examiniation there were no skin rash of eschar, and no palpable lymph nodes. Laboratory findings showed leukocytosis with shift to left and mild
anemia.
BUN and creatinine were markedly elevated. Acute peritoneal dialysis was performed because anuria persisted in spite of vigrous hydration and diuretic treatment. Rickettsia tsutsugamushi infection was confirmed by hemagglutination test. Renal
biopsy was
performed under the guide of ultrasonography after improvement of renal function. Renal pathology was consistent with acute interstitial nephritis. Diffuse interstitial edema and multifocal patch cellular infiltration were observed in the
cortexd.
There
was also periglomerular and perivenular infiltration, mostl composed by mononuclear and plalsma cells. The glomeruli and tubules showed no obvious changes. The patient recovered complietely without any sequelae.
Acute renal failure due to Rickettsia tsutsugamushi in children is extremely rare. We report a case of successfully treated patient with peritoneal dialysis of acute renal failure due to Rickettsia tsutsugamushi as a first case in Korea.
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