Zhang CG, Duan M, Zhang XY, Wang Y, Wu S, Feng LL, Song LL, Chen XY. Klebsiella pneumoniae infection secondary to spontaneous renal rupture that presents only as fever: A case report. World J Clin Cases 2021; 9(11): 2602-2610 [PMID: 33889626 DOI: 10.12998/wjcc.v9.i11.2602]
Corresponding Author of This Article
Xu-Yan Chen, MD, PhD, Doctor, Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. cxya00559@btch.edu.cn
Research Domain of This Article
Emergency Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 16, 2021; 9(11): 2602-2610 Published online Apr 16, 2021. doi: 10.12998/wjcc.v9.i11.2602
Klebsiella pneumoniae infection secondary to spontaneous renal rupture that presents only as fever: A case report
Chen-Guang Zhang, Min Duan, Xiang-Yang Zhang, Yan Wang, Sheng Wu, Li-Li Feng, Lin-Lin Song, Xu-Yan Chen
Chen-Guang Zhang, Min Duan, Xiang-Yang Zhang, Yan Wang, Sheng Wu, Li-Li Feng, Lin-Lin Song, Xu-Yan Chen, Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
Author contributions: Zhang CG was in charge of this patient, reviewed the literature, and contributed to manuscript drafting; Wang Y and Duan M reviewed the literature and contributed to formal analysis; Zhang XY, Song LL, and Feng LL analyzed and interpreted the figures; Wu S and Chen XY were responsible for the revision of the manuscript; all authors provided final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to report. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xu-Yan Chen, MD, PhD, Doctor, Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. cxya00559@btch.edu.cn
Received: December 6, 2020 Peer-review started: December 6, 2020 First decision: January 10, 2021 Revised: January 19, 2020 Accepted: February 9, 2021 Article in press: February 9, 2021 Published online: April 16, 2021
Abstract
BACKGROUND
Spontaneous renal rupture is a rare disease in the clinic. The causes of spontaneous renal rupture include extrarenal factors, intrarenal factors, and idiopathic factors. Reports on infection secondary to spontaneous renal rupture and the complications of spontaneous renal rupture are scarce. Furthermore, there are few patients with spontaneous renal rupture who present only with fever.
CASE SUMMARY
We present the case of a 52-year-old female patient who was admitted to our hospital. She presented only with fever, and the cause of the disease was unclear. She underwent a contrast-enhanced computed tomography (CT) scan, which showed that the left renal capsule had a crescent-shaped, low-density shadow; the perirenal fat was blurred, and exudation was visible with no sign of calculi, malignancies, instrumentation, or trauma. Under ultrasound guidance, a pigtail catheter was inserted into the hematoma, and fluid was drained and used for the bacterial test, which proved the presence of Klebsiella pneumoniae. Two months later, abdominal CT showed that the hematoma was absorbed, so the drainage tube was removed. The abdominal CT was normal after 4 mo.
CONCLUSION
Spontaneous renal rupture due to intrarenal factors causes a higher proportion of shock and is more likely to cause anemia.
Core Tip: Spontaneous rupture of the kidney is uncommon in the clinic. The causes of spontaneous renal rupture include extrarenal factors, intrarenal factors, and idiopathic factors. We present a case whose symptoms were atypical and who presented only with fever. The cause of the disease was unclear. Infection secondary to the perinephric hematoma was shown, with clear etiological evidence of Klebsiella pneumoniae infection. This case highlights the importance of identifying the cause and determining the location of the rupture, and the treatment can be given according to the causative pathogen. Moreover, more attention should be paid to comorbidities, especially those caused by intrarenal factors, which are more fatal than other factors.
