RESUMO
Emphysematous pyelonephritis (EPN) is a rapidly progressive and life-threatening infection that is seen most commonly in persons with diabetes. The infecting organisms usually consist of mixed flora, including Escherichia coli (68%), Klebsiella pneumoniae (9%) and Proteus mirabilis. Females are affected twice as often as men, and mortality rates can be as high as 80%. Obstructive uropathy, urinary calculi, calyceal stenosis and neoplasms are significant predisposing factors. We report a case of EPN in a patient with the human immunodeficiency virus infection, without diabetes mellitus or urinary tract obstruction, which responded remarkably to conservative management with antibiotics alone.
Assuntos
Coinfecção , Enfisema/microbiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/isolamento & purificação , Infecções por HIV/complicações , Pielonefrite/microbiologia , Adulto , Antibacterianos/uso terapêutico , Enfisema/complicações , Enfisema/diagnóstico , Enfisema/tratamento farmacológico , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/tratamento farmacológico , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , HIV-1/isolamento & purificação , Humanos , Pielonefrite/complicações , Pielonefrite/diagnóstico , Pielonefrite/tratamento farmacológico , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
A 20-year-old student presented with generalized tonic-clonic seizures and was diagnosed to have cortical venous thrombosis. Her dietary history and the clinical signs of vitamin deficiency prompted further investigations, which detected hyperhomocysteinaemia secondary to vitamin B12 deficiency as a factor contributing to the hypercoagulable state. This case highlights the importance of a balanced diet, as well as the necessity for primordial prevention.