Pediatric Infection and Vaccine

  • 제26권2호
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  • Pages.118-123
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  • 2019
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  • 2384-1079(pISSN)
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  • 2384-1087(eISSN)
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)
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Postinfectious Glomerulonephritis Associated with Pneumococcus and Influenza A Virus Infection in a Child: a Case Report and Literature Review

  • Huh, Homin (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Lee, Joon Kee (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Yun, Ki Wook (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Kang, Hee Gyung (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Cheong, Hae Il (Department of Pediatrics, Seoul National University Children's Hospital)
  • 투고 : 2018.11.08
  • 심사 : 2019.05.16
  • 발행 : 2019.08.25
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초록

감염 후 사구체신염(postinfectious glomerulonephritis, PIGN)은 주로 Streptococcus pyogenes에 의해 발생하지만, 다른 병원체와 관련된 PIGN도 문헌에서 확인된다. 기침, 발열, 우측 흉통을 주소로 내원한 6세 남아에서 폐구균 및 인플루엔자 A 바이러스의 감염이 확인되었고 항생제와 항바이러스제가 투약되었다. 입원 중 전신 부종, 혈뇨, 단백뇨, 혈압의 상승이 관찰되었고, 따라서 이뇨제가 투약되었다. 환자는 육안적 혈뇨가 관찰되는 상태로 퇴원하였고, 퇴원 후 14주에 현미경적 혈뇨까지 사라졌다. 폐구균 또는 인플루엔자 A 바이러스 감염이 확인된 환아에서 신염의 증상이 보이는 경우 감염 후 사구체신염의 조기발견을 위해 소변검사 및 혈압의 측정이 이루어져야 한다. 본 저자들은 폐구균 및 인플루엔자 A 바이러스에 의한 감염 후 사구체신염 사례를 경험하였기에 이를 보고하는 바이다.

Postinfectious glomerulonephritis (PIGN) is most commonly caused by Streptococcus pyogenes in children, but PIGN associated with other pathogens has been described in the literature. A previously healthy 6-year-old boy was admitted with complaints of cough, fever, and right chest pain. The patient was diagnosed with pneumococcal bacteremia and influenza A virus infection and treated with antibiotics and antiviral agent. During hospitalization, generalized edema, hematuria, proteinuria, and increased blood pressure were observed; therefore, we started administering diuretics. The boy was discharged with gross hematuria, and even microscopic hematuria disappeared 14 weeks after discharge. We report a case of PIGN associated with bacteremic pneumococcal pneumonia and influenza A virus infection in children. A urine test and blood pressure measurement should be considered for the early detection of PIGN in children with pneumococcal or influenza A virus infection when they present with nephritic symptoms.

키워드

참고문헌

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피인용 문헌

  1. 뇌병증 또는 근염으로 발현된 소아 인플루엔자 감염 2례 vol.17, pp.3, 2019, https://doi.org/10.22730/jmls.2020.17.3.98