非傷寒沙門氏菌感染造成產氣性腎盂腎炎合併壞死性筋膜炎:病例報告及文獻回顧

陳正哲、謝享宸、裘坤元

台中榮民總醫院 外科部 泌尿外科

Nontyphoidal Salmonella Emphysematous pyelonephritis and necrotizing fasciitis: A case report and review of the literature

 Cheng-Che Chen、Hsiang-Chen Hsieh、Kun-Yuan Chiu

Divisions of Urology, Department of Surgery, Taichung Veterans General Hospital

Abstract:

Nontyphoidal Salmonellae are an important bacterial which common cause gastrointestinal disease. However, they can also progress to any site. The most isolated origins are stool, blood and urine. Emphysematous pyelonephritis (EPN) and necrotizing fasciitis are rare and life-threatening diseases which needs well-drainage or debridement and adequate antibiotics treatment. Nontyphoidal salmonella emphysematous pyelonephritis is rarely published before.

Here, we present a 53-year-old man who presented with fever and left flank pain for weeks. Computed tomography showed huge amount of abscess formation around whole kidney and dissecting along psoas muscles to left iliac vessels. There is also air within left kidney. Radical nephrectomy and fasciotomy was performed. Salmonella group D was isolated from the abscess. The patient was successfully treated with antibiotics and operation.

To our knowledge, this is the first case report in the literature of EPN with necrotizing fasciitis caused by Salmonella.