ABSTRACT
Postinfectious streptococcal glomerulonephritis (PSGN) presenting as a rapidly progressive glomerulonephritis (RPGN) and nephrotic syndrome (NS) is a rare disease in elderly patients. Here we report a case of PSGN with RPGN and NS in an elderly male patient with a complete recovery from his illness. A 73-year-old man was admitted for dyspnea, oliguria and generalized edema appearing after acute upper respiratory infection. On admission, he presented nephrotic range of proteinuria, decreased renal function with elevated ASO, and decreased C3 and CH50 concentrations. The renal biopsy showed marked cellular crescents in the glomeruli with collapsed glomerular tufts and inflammatory cell infiltration. There were prominent and various sizes of "humps" in subepithelial areas in electron microscopy. Under the diagnosis of PSGN with RPGN, we successfully treated the patient with steroid pulse therapy and hemodialysis. We would suggest that early diagnosis and aggressive steroid therapy should be indicated in the treatment of PSGN with RPGN.
Subject(s)
Aged , Humans , Male , Biopsy , Diagnosis , Dyspnea , Early Diagnosis , Edema , Glomerulonephritis , Microscopy, Electron , Nephrotic Syndrome , Oliguria , Proteinuria , Rare Diseases , Renal DialysisABSTRACT
Ischemic nephropathy is defined as renal dysfunction due to renal hypoperfusion mainly through renal artery stenosis. It is a common cause of chronic renal failure in old patients with atherosclerosis and is also a potentially correctable cause of renal failure if diagnosed earlier. We experienced a case of sudden Rt. main renal artery occlusion and renal failure after femoral artery angioplasty in an aged male patient with underlying atherosclerotic bilateral renovascular stenosis associated with ischemic nephropathy. He received successful Lt. renal artery angioplasty with stenting and restored Lt. renal artery blood flow. His blood pressure was more easily controlled with fewer antihypertensive drugs after renal artery revascularization. His renal function was recovered to his baseline level and became stabilized thereafter. Early diagnosis of ischemic nephropathy with MRA and timely renal angioplasty with stenting are beneficial to avoiding progression to irreversible renal failure.
Subject(s)
Humans , Male , Angioplasty , Antihypertensive Agents , Atherosclerosis , Blood Pressure , Constriction, Pathologic , Early Diagnosis , Femoral Artery , Kidney Failure, Chronic , Renal Artery Obstruction , Renal Artery , Renal Insufficiency , StentsABSTRACT
Non-O1, non-O139 Vibrio cholerae usually causes gastroenteritis and bacteremia. It can also cause skin and soft tissue infection but the incidence is very rare. Patients who have been reported to have skin and soft tissue infection caused by non-O1, non-O139 V. cholerae had liver cirrhosis or chronic hepatitis. We present here a case of skin and soft tissue infection caused by non-O1, non- O139 V. cholerae in a patient with liver cirrhosis in Korea. After treatment of cefotaxime, doxycycline and debridement, the wound was clinically improved. This case suggests that non-O1, non-O139 V. cholerae infection should also be considered in addition to V. vulnificus infection when skin and soft tissue infections occurs in patients with liver cirrhosis, especially if they have had seawater or seafood exposure.
Subject(s)
Humans , Bacteremia , Cefotaxime , Cholera , Debridement , Doxycycline , Gastroenteritis , Hepatitis, Chronic , Incidence , Korea , Liver Cirrhosis , Liver , Seafood , Seawater , Skin , Soft Tissue Infections , Vibrio cholerae , Vibrio , Wounds and InjuriesABSTRACT
Non-O1, non-O139 Vibrio cholerae usually causes gastroenteritis and bacteremia. It can also cause skin and soft tissue infection but the incidence is very rare. Patients who have been reported to have skin and soft tissue infection caused by non-O1, non-O139 V. cholerae had liver cirrhosis or chronic hepatitis. We present here a case of skin and soft tissue infection caused by non-O1, non- O139 V. cholerae in a patient with liver cirrhosis in Korea. After treatment of cefotaxime, doxycycline and debridement, the wound was clinically improved. This case suggests that non-O1, non-O139 V. cholerae infection should also be considered in addition to V. vulnificus infection when skin and soft tissue infections occurs in patients with liver cirrhosis, especially if they have had seawater or seafood exposure.