Cases reported "Kidney Calculi"

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1/3. Staghorn calculus endotoxin expression in sepsis.

    Staghorn calculi are infrequent and generally are infected stones. Struvite or apatite calculi are embedded with gram-negative bacteria, which can produce endotoxin. sepsis syndrome may occur after surgical therapy or endoscopic manipulation of infected or staghorn calculi. sepsis, which can occur despite perioperative antibiotic use, may be due to bacteremia or endotoxemia. We present a child with an infected staghorn calculus who developed overwhelming sepsis and died after percutaneous stone manipulation. Endotoxin assay of stone fragments demonstrated an extremely high level of endotoxin despite low colony bacterial culture growth. This is the first reported case in which endotoxin was demonstrated in stone fragments from a child who died of severe sepsis syndrome after percutaneous staghorn stone manipulation.
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keywords = endotoxin
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2/3. polymyxin b-immobilized fiber hemoperfusion with low priming volume in an elderly septic shock patient with marked endotoxemia.

    An 84-year-old woman with septic shock caused by pyelonephritis is described herein. She was admitted for severe back pain and high fever. Her white blood cell (WBC) count and c-reactive protein (CRP) and endotoxin levels were elevated at 38,000/microl, 40.0 mg/dl, and 8,400 pg/ml, respectively. Her blood pressure was 80/34 mm Hg. urinalysis revealed occult blood with innumerable WBCs. Plain abdominal radiography showed calcium stones in both kidneys. Septic shock with endotoxemia was diagnosed, and the patient was treated with antibiotics, gamma-globulin, and dopamine. However, her plasma endotoxin level remained high for 3 days. We performed direct hemoperfusion twice using a polymyxin b-immobilized fiber (PMX-F) column with a low priming volume. After PMX-F treatment, the patient's temperature decreased to 36.8 degrees C; her WBC count and CRP level decreased to 9,200/microl and 3.8 mg/dl, respectively. Her plasma endotoxin level decreased to 840 pg/ml after the first treatment and to 188 pg/ml after the second treatment. The next day, her blood endotoxin level further decreased to 32 pg/ml. Her blood pressure increased to 92/60 mm Hg after the first treatment and to 118/76 mm Hg after the second treatment. The patient was discharged on day 26 after admission. Our experience in this case suggests that PMX-F treatment with a low priming volume may be beneficial in elderly patients with septic shock and marked endotoxemia.
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ranking = 0.57142857142857
keywords = endotoxin
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3/3. Successful treatment with polymyxin b immobilized fiber of septic shock complicated by renal stone.

    We describe a patient with septic shock that was spontaneously complicated by calyceal diverticular calculus. The patient recovered from shock within a few days with treatment by extracorporeal elimination of endotoxin using a blood purification cartridge consisting of polymyxin b immobilized fiber. Standard open nephrolithotomy was performed, and the patient was discharged from the hospital 2 months after admission.
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ranking = 0.14285714285714
keywords = endotoxin
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