Systemic inflammatory response syndrome and acute renal failure associatedwith Hemophilus influenzae septic meningitis

Sepsis is often associated with a downward spiral through a spectrum of sys temic inflammatory response syndrome (SIRS) culminating in organ failure an d death. Here we present a 3-year-old girl with Hemophilus influenzae septi c meningitis who developed SIRS and acute renal failure. In the initial sta ge, the patient showed uremia, cytopenia, disseminated intravascular coagul ation, elevation of tissue enzyme and ferritin values, hemophagocytosis and overproduction of nitric oxide. The serum cytokine profile revealed increa sed levels of soluble interleukin (IL)-2 receptor, IL-6, IL-10 and tumor ne crosis factor alpha. The patient responded positively to early and intensiv e interventions including antibiotics, repeated exchange transfusions, dexa methasone and high-dose gamma-globulin. The above laboratory abnormalities almost normalized with clinical improvement. We consider that SIRS was prob ably responsible for the sequence of events resulting in renal failure in t his case, and suggest that renal failure should be included among the serio us complications of SIRS associated with Hemophilus influenzae septic menin gitis. Copyright (C) 2000 S. Karger AG, Basel.