title: Systemic inflammatory response syndrome and acute renal failure associated with Hemophilus influenzae septic meningitis.
abstract: Sepsis is often associated with a downward spiral through a spectrum of systemic inflammatory response syndrome (SIRS) culminating in organ failure and death. Here we present a 3-year-old girl with Hemophilus influenzae septic meningitis who developed SIRS and acute renal failure. In the initial stage, the patient showed uremia, cytopenia, disseminated intravascular coagulation, elevation of tissue enzyme and ferritin values, hemophagocytosis and overproduction of nitric oxide. The serum cytokine profile revealed increased levels of soluble interleukin (IL)-2 receptor, IL-6, IL-10 and tumor necrosis factor alpha. The patient responded positively to early and intensive interventions including antibiotics, repeated exchange transfusions, dexamethasone and high-dose gamma-globulin. The above laboratory abnormalities almost normalized with clinical improvement. We consider that SIRS was probably responsible for the sequence of events resulting in renal failure in this case, and suggest that renal failure should be included among the serious complications of SIRS associated with Hemophilus influenzae septic meningitis.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Fukui Medical University, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nishimura
authors.forename: H
authors.initials: H
authors.lastname: Tsukahara
authors.forename: M
authors.initials: M
authors.lastname: Hiraoka
authors.forename: Y
authors.initials: Y
authors.lastname: Osaka
authors.forename: Y
authors.initials: Y
authors.lastname: Ohshima
authors.forename: A
authors.initials: A
authors.lastname: Tanizawa
authors.forename: M
authors.initials: M
authors.lastname: Mayumi
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008583:Meningitis, Haemophilus / Q000150:complications* / Q000628:therapy; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications* / Q000382:microbiology / Q000628:therapy