以发热为主要症状的自发性肾出血继发感染1例并文献复习

Secondary infection of spontaneous perirenal hemorrhage with fever as the main symptom:A case report and literature review

目的总结以发热为主要症状的自发性肾出血(spontaneous perirenal hemorrhage,SPH)有效鉴别诊断及治疗方法。方法回顾性分析1例不典型症状为首发表现的SPH的临床资料,并结合文献进行讨论。结果患者老年男性,以“发热10 d,血肌酐升高1周”入院。无外伤及手术史,临床表现仅为高热,无腰痛、腹痛、休克等症状,结合实验室及影像学检查,诊断为SPH。经超声引导下穿刺引流及抗感染治疗,患者体温恢复正常。结论临床医生有必要充分了解SPH不典型症状,以期为临床诊治此类疾病提供依据和经验。

Objective To summarize the effective differential diagnosis and treatment of spontaneous perirenal hemorrhage(SPH)with fever as the main symptom.Methods The clinical data of a case of SPH with atypical first manifestations were retrospectively analyzed.Relevant literatures were reviewed as well.Results An elderly male patient was admitted for 10-day fever and 1-week elevation of blood creatinine.He denied trauma and surgery history.Fever was the only clinical manifestation,and lumbar pain,abdominal pain and shock were absent.After laboratory testing and imaging examination,the patient was diagnosed as SPH.Body temperature returned normal after ultrasound-guided puncture drainage and anti-infectious therapy.Conclusion It is necessary for clinicians to master atypical manifestations of SPH,so as to provide references and clinical experiences.