Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
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
Processing time: 115 Days and 19 Hours
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.

Keywords: Spontaneous; Renal rupture; Klebsiella pneumoniae; Fever; Infection; Case report

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.