1/13. Peripheral gangrene complicating idiopathic and recessive hemolytic uremic syndromes.Three patients with hemolytic uremic syndrome (HUS) developed peripheral gangrene. Bilateral carotid artery thromboses occurred in one of these patients after recovery from HUS. One patient had a long history of juvenile rheumatoid arthritis. In the second patient, a flu-like illness preceded the onset of HUS. The third was one of two sisters, with the HUS appearing more than 1 year apart. None had evidence of disseminated intravascular coagulation or infection with streptococcus pneumoniae. The patient with rheumatoid arthritis had renal cortical necrosis but recovered moderate renal function after treatment with dialysis and plasmapheresis for 6 months. The child with a genetic form of HUS died of renal failure and had massive cortical necrosis and vascular thrombosis at autopsy. This is the first report of peripheral gangrene in children with idiopathic HUS and autosomal recessive HUS.- - - - - - - - - - ranking = 1keywords = pneumoniae (Clic here for more details about this article) |
2/13. Renal transplantation after streptococcus pneumoniae-associated hemolytic uremic syndrome.Of the several causes of nondiarrheal hemolytic uremic syndrome (HUS), infection with streptococcus pneumoniae is infrequent, but important, because of its unique pathogenesis. A comprehensive literature review found 37 well-documented cases of S pneumoniae-associated HUS (SP-HUS), only 2 of which progressed to end-stage renal disease (ESRD). We report the third such child, and the first to receive a renal transplant following SP-HUS. Her course illustrates several unique characteristics of SP-HUS common to previous patients reported in the literature, including a greater duration of oligoanuria compared with cases not progressing to ESRD, the significant adverse effect of unwashed blood products, and a possible influence of female gender on outcome. Clinicians caring for children with SP-HUS should be aware of these differences and modify therapy appropriately to avoid known risk factors for poor outcome, specifically the use of unwashed blood products.- - - - - - - - - - ranking = 6keywords = pneumoniae (Clic here for more details about this article) |
3/13. Hemolytic uremic syndrome associated with group A beta-hemolytic streptococcus.Group A beta-hemolytic streptococcal (GABS) hemorrhagic colitis due to streptococcus pyogenes is extremely rare and its association with hemolytic uremic syndrome (HUS) in children has not been described. We report a 9-year-old white male who developed biopsy-proven HUS while continuing to have GABS-positive bloody diarrhea. Renal function deteriorated rapidly requiring intermittent hemodialysis. Three months following discharge, his renal function is normal for age except for significant proteinuria.- - - - - - - - - - ranking = 6.5525065511636keywords = streptococcus (Clic here for more details about this article) |
4/13. Antibiotic resistant streptococcus pneumoniae and hemolytic uremic syndrome.The hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in young children and most often follows an episode of gastroenteritis caused by an enterohemorrhagic strain of escherichia coli (O157:H7). HUS induced by streptococcus pneumoniae (SP) is rare. We report an 18-month-old patient who presented with HUS associated with SP resistant to penicillin and cephalosporins. CONCLUSION: Despite a protracted course including renal failure requiring 15 days of peritoneal dialysis, her kidney function completely recovered.- - - - - - - - - - ranking = 5keywords = pneumoniae (Clic here for more details about this article) |
5/13. A preventable illness? Purulent pericarditis due to streptococcus pneumoniae complicated by haemolytic uraemic syndrome in an infant.A previously healthy eight-month-old infant presented with shortness of breath and pyrexia. He was found to have purulent pericarditis due to streptococcus pneumoniae, complicated by acute renal failure due to haemolytic uraemic syndrome. He received peritoneal dialysis and recovered with normalisation of renal function. This case highlights two important complications of pneumococcal infection in one individual and illustrates the need for rapid diagnosis and treatment of invasive pneumococcal disease. It is anticipated that introduction of the conjugate pneumococcal vaccination to the Australian Standard vaccination Schedule from 2005 will reduce the incidence of pneumococcal infection and its associated morbidity and mortality.- - - - - - - - - - ranking = 5keywords = pneumoniae (Clic here for more details about this article) |
6/13. Hemolytic uremic syndrome associated with invasive streptococcus pneumoniae infection: report of one case.Hemolytic uremic syndrome (HUS) most commonly follows an episode of gastroenteritis associated with escherichia coli (O157:H7). S. pneumoniae-associated HUS is rare and has been reported having a high morbidity and mortality rate. We present a 1-year-5-month-old girl who developed S. pneumoniae-associated HUS and positive T-activation testing. She received antibiotics, washed red blood cell transfusion and early continuous venovenous hemodiafiltration treatment. She had chronic renal failure but was without other sequelae after 8 months, follow-up. Early dialysis intervention in S. pneumoiae-induced HUS patients decreasing the morbidity and mortality rate is discussed, and the literature is reviewed.- - - - - - - - - - ranking = 6keywords = pneumoniae (Clic here for more details about this article) |
7/13. Haemolytic-uraemic syndrome associated with streptococcus pneumoniae meningitis.We report the first case of Haemolytic-uraemic syndrome (HUS) associated with streptococcus pneumoniae meningitis. This supports a common pathogenic mechanism in HUS following infections by neuraminidase-producing organisms and in pneumococcal meningitis. We recommend that HUS must be considered in cases of renal failure and/or anaemia associated with pneumococcal meningitis, and that bacterial meningitis be considered in all patients with HUS and central nervous system involvement.- - - - - - - - - - ranking = 5.2557476415051keywords = pneumoniae, meningitis (Clic here for more details about this article) |
8/13. hemolytic-uremic syndrome associated with streptococcus pneumoniae. Report of a case and review of the literature.A child aged 2 years 3 months with streptococcus pneumoniae sepsis and pulmonary abscesses had hemolytic-uremic syndrome and acute renal failure develop that required 36 cycles of peritoneal dialysis. A percutaneous renal biopsy specimen taken after dialysis showed mesangial proliferation with interposition, hemorrhagic crescents, and intracapillary thrombosis with fibrinogen and IgM deposition. The atrophic renal tubules showed positive immunofluorescence against peanut agglutinin. neuraminidase released by pneumococcal organisms is thought to expose the Thomsen-Friedenreich antigen on platelets, erythrocytes, and kidneys, resulting in IgM deposition and binding of peanut agglutinin. review of the literature showed four other reports involving five children who had hemolytic-uremic syndrome develop secondary to pneumococcal infections.- - - - - - - - - - ranking = 5keywords = pneumoniae (Clic here for more details about this article) |
9/13. streptococcus pneumoniae-induced hemolytic uremic syndrome: a case for early diagnosis.Hemolytic uremic syndrome associated with infection by neuraminidase-producing streptococcus pneumoniae usually presents with fulminant pneumonia and has a high mortality rate. Post-pneumococcal hemolytic uremic syndrome may occur earlier in life than classical hemolytic uremic syndrome. We describe an 18-month-old male with hemolytic uremic syndrome, S. pneumoniae pneumonia, and T-antigen activation characteristic of neuraminidase activity. We have summarized the features of this case and 11 previously reported children. As the use of blood products containing IgM may aggravate this disorder, early recognition of hemolytic uremic syndrome associated with S. pneumoniae neuraminidase production may lead to improved patient outcome through the judicious use of blood products.- - - - - - - - - - ranking = 7keywords = pneumoniae (Clic here for more details about this article) |
10/13. Hepatocellular injury in streptococcus pneumoniae-associated hemolytic uremic syndrome in children.streptococcus pneumoniae is an uncommon etiological organism in hemolytic uremic syndrome (HUS). Production of neuraminidase by S. pneumoniae results in exposure of red blood cell T-antigen, resulting in hemolysis, thrombocytopenia, and acute renal failure. Hepatic involvement in this form of HUS has not been described in the literature. We report in three children with S. pneumoniae-associated HUS the presence of severely elevated transaminases and conjugated hyperbilirubinemia. Increases in asparagine transaminase ranged from 11 to 46 times normal values and an increase in alanine transaminase ranged from 1.6 to 8 times normal. In all patients the rise in total bilirubin was 7-15 times normal. Biliary tree obstruction and viral causes for liver dysfunction were absent. Hepatocellular injury in S. pneumoniae-associated HUS likely results from mechanisms involved in sepsis and pneumonia-induced jaundice, combined with severely increased bilirubin production following massive hemolysis. The hepatic injury in all three patients resolved within 9, 5, and 10 days. Our experience suggests that an extensive evaluation including liver biopsy is not indicated.- - - - - - - - - - ranking = 8keywords = pneumoniae (Clic here for more details about this article) |
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