RESUMO
Dialysis patients have greater number of complications due to multiple comor-bidity and access-related infections as well as nosocomial infections due to reduced immunity and more frequent hospitalizations. Endogenous endophthalmitis is a potentially blinding ocular infection occurring in chronically debilitated patients and the use of invasive procedures. Symmetric peripheral gangrene (SPG) is defined as symmetrical distal ischemic damage in two or more sites in the absence of a major vascular occlusive disease. It carries a high mortality rate with a very high frequency of multiple limb amputations in the survivors. However, only a few case reports have described endogenous endophthalmitis in dialysis patients. Concomitant endophthalmitis and disseminated intravascular coagulation (DIC), presenting as SPG, is extremely rare and no such case was found in the literature survey. Herein, we report a very rare association of bilateral endophthalmitis with DIC and SPG in a patient with chronic kidney disease on maintenance hemodialysis.
Assuntos
Coagulação Intravascular Disseminada/etiologia , Endoftalmite/etiologia , Infecções Oportunistas/etiologia , Diálise Renal/efeitos adversos , Insuficiência Renal Crônica/terapia , Sepse/etiologia , Infecções por Serratia/etiologia , Coagulação Intravascular Disseminada/diagnóstico , Coagulação Intravascular Disseminada/terapia , Endoftalmite/imunologia , Endoftalmite/microbiologia , Endoftalmite/terapia , Evolução Fatal , Feminino , Gangrena , Humanos , Hospedeiro Imunocomprometido , Pessoa de Meia-Idade , Infecções Oportunistas/imunologia , Infecções Oportunistas/microbiologia , Infecções Oportunistas/terapia , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/imunologia , Sepse/imunologia , Sepse/microbiologia , Sepse/terapia , Infecções por Serratia/imunologia , Infecções por Serratia/microbiologia , Infecções por Serratia/terapia , Resultado do TratamentoRESUMO
Chronic kidney disease (CKD) and end-stage renal disease are a global health problem worldwide. In developing countries, it is a particular challenge to deliver optimal hemodialysis (HD) due to prevailing socioeconomic conditions. This has multiple downstream effects, including frequent hospitalizations and increased morbidity. We conducted this retrospective study to identify the etiology of hospital admission in HD patients and to detect the duration and costs associated with their hospitalizations. A total of 42 maintenance HD patients were hospitalized during this time frame and their hospitalizations were studied for the purpose of this study. CKD is growing global public health problem causing socioeconomic impact. Hence, early detection and referral to nephrology services can reduce hospitalization rates after a planned dialysis start thus might improve patients' quality of life.