A Case of Acute Renal Failure Resulting from Murine Typhus Infection Induced Acute Tubulointerstitial Nephritis / 대한신장학회잡지

ABSTRACT

Murine typhus is an infectious disease caused by Rickettsia typhi, an intracellular parasite that lives in the cytoplasm of host cells. Rickettsia typhi infection can induce lymphohistiocytic vasculitis leading to pulmonary, cardiovascular, central nervous system and renal complications. We experienced a case of acute renal failure resulting from acute tubulointerstitial nephritis associated with murine typhus infection. A 67 year old man was transferred from local hospital due to fever, confusion, oliguria with renal failure. Laboratory finding showed elevated liver enzyme with hypoalbuminemia and progressive azotemia. Despite supportive care, his azotemia progressed with anuria and acute hemodialysis was started. Kidney biopsy showed acute tubulointerstitial nephritis with vasculitis and indirect immunofluorecent antibody to murine typhus was 1: 3, 200. Doxycyclin was started and his renal function recovered. We report a case of acute renal failure resulting from murine typhus infection induced acute tubulointerstitial nephritis.