Subject(s)
Emphysema/diagnostic imaging , Escherichia coli Infections/diagnostic imaging , Escherichia coli/isolation & purification , Kidney/pathology , Pyelitis/diagnostic imaging , Anti-Bacterial Agents/therapeutic use , Ceftriaxone/therapeutic use , Child, Preschool , Emphysema/drug therapy , Emphysema/microbiology , Escherichia coli Infections/drug therapy , Escherichia coli Infections/microbiology , Female , Humans , Kidney/diagnostic imaging , Nephrectomy/methods , Pyelitis/drug therapy , Pyelitis/microbiology , Tomography, X-Ray ComputedABSTRACT
Diagnosis of encrusted pyelitis in predisposed patients is difficult. The bacteriology laboratory must be specifically asked to perform the appropriate tests. Computed tomography without injection is very important for diagnosis and follow-up. Conservative treatment is essential insofar as possible. Long-term follow-up is also necessary.
Subject(s)
Pyelitis/diagnosis , Pyelitis/drug therapy , Early Diagnosis , Humans , Kidney Calculi/complications , Kidney Calculi/microbiology , Pyelitis/complications , Pyelitis/microbiologyABSTRACT
Encrusted pyelitis is a chronic urinary tract infection associated with mucosal encrustation induced by urea splitting bacteria. More than 40 bacteria have been implicated but the most frequent is Corynebacterium group D2. Predisposing factors are debilitating chronic diseases and preexisting urological procedures. Immunosoppression is an important cofactor. For these reasons the disease is almost always nosocomially acquired and renal transplant recipients are at particular risk. The symptoms are not specific and long lasting: dysuria, flank pain and gross haematuria are the most frequent; fever is present in two-thirds. The demonstration of urine splitting bacteria in constantly alkaline urines and radiological evidence of extensive calcification of pelvicalyceal system, ureter and bladder at US or CT scan in a clinical context of predisposing factors are the mainstay of diagnosis. Treatment is based on adapted antibiotic therapy, acidification of urine and excision of plaques of calcified encrustation. The prognosis relies on timing of diagnosis; delay can be detrimental and result in patient's death and graft loss. We describe a unique case of 69-year-old man with two contemporary diseases: autoimmune thrombotic thrombocytopenic purpura and encrusted pyelitis with a fatal evolution.
Subject(s)
Enterobacteriaceae Infections/etiology , Morganella morganii/isolation & purification , Nephrocalcinosis/etiology , Purpura, Thrombotic Thrombocytopenic/complications , Pyelitis/etiology , Staphylococcal Infections/etiology , Aged , Anti-Bacterial Agents/therapeutic use , Coinfection/drug therapy , Combined Modality Therapy , Disease Susceptibility , Enterobacteriaceae Infections/drug therapy , Fatal Outcome , Hematuria/etiology , Humans , Hydronephrosis/diagnostic imaging , Hydronephrosis/etiology , Male , Nephrocalcinosis/diagnostic imaging , Nephrotomy , Plasma Exchange , Purpura, Thrombotic Thrombocytopenic/drug therapy , Purpura, Thrombotic Thrombocytopenic/therapy , Pyelitis/diagnostic imaging , Pyelitis/drug therapy , Rituximab/therapeutic use , Staphylococcal Infections/drug therapyABSTRACT
Encrusted cystitis is a very rare chronic inflammatory disease of the bladder characterized by precipitation and incrustation of phosphate and ammonium-magnesium salts on the vescical mucosa, caused by urinary infection due to urolithic microorganisms. Corynebacterium urealyticum or Corynebacterium group D2, a multiple antibiotic-resistant urea-splitting bacterium, is the most frequently incriminated aetiology. We report a case of a 57-year-old man affected by systemic erythematosus lupus with a long history of dysuria and suprapubic pain who underwent percutaneous nephrostomy drainage with urethral stenting for lupoid obstructive uropathy. Before the diagnosis of encrusted cystitis by Corynebacterium urealyticum was established, the patient underwent five cystoscopies to remove the plaques and multiple unsuccessful antibiotic treatment courses. Eventually the infection was definitively cured after a two-week course with intramuscular teicoplanin.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Corynebacterium Infections/drug therapy , Cystitis/drug therapy , Apatites/analysis , Bacterial Proteins/metabolism , Chemical Precipitation , Chronic Disease , Combined Modality Therapy , Corynebacterium/classification , Corynebacterium/drug effects , Corynebacterium/isolation & purification , Corynebacterium/metabolism , Corynebacterium Infections/etiology , Corynebacterium Infections/metabolism , Corynebacterium Infections/surgery , Crystallization , Cystitis/etiology , Cystitis/metabolism , Cystitis/microbiology , Cystitis/surgery , Drug Resistance, Multiple, Bacterial , Humans , Hydronephrosis/etiology , Hydronephrosis/surgery , Immunocompromised Host , Lupus Erythematosus, Systemic/complications , Magnesium Compounds/analysis , Male , Nephrostomy, Percutaneous , Phosphates/analysis , Pyelitis/drug therapy , Pyelitis/microbiology , Remission Induction , Stents , Struvite , Teicoplanin/therapeutic use , Urease/metabolismSubject(s)
Corynebacterium Infections/diagnostic imaging , Kidney Pelvis/diagnostic imaging , Kidney Transplantation , Pyelitis/diagnostic imaging , Chronic Disease , Corynebacterium Infections/diagnosis , Corynebacterium Infections/drug therapy , Humans , Kidney Failure, Chronic/microbiology , Kidney Failure, Chronic/therapy , Kidney Transplantation/adverse effects , Male , Middle Aged , Opportunistic Infections/diagnosis , Opportunistic Infections/diagnostic imaging , Opportunistic Infections/drug therapy , Pyelitis/diagnosis , Pyelitis/drug therapy , Tomography, X-Ray Computed , Ureter/diagnostic imagingSubject(s)
Catheters, Indwelling , Cystitis/diagnostic imaging , Cystostomy , Emphysema/diagnostic imaging , Enterobacteriaceae Infections/diagnosis , Pyelitis/diagnostic imaging , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Citrobacter , Cystitis/drug therapy , Enterobacter cloacae , Enterobacteriaceae Infections/drug therapy , Humans , Male , Prostatic Hyperplasia/complications , Pyelitis/drug therapy , Urethral Stricture/complications , Urinary Bladder Neck Obstruction/etiology , Urinary Bladder Neck Obstruction/therapy , Urinary Tract InfectionsABSTRACT
We evaluated the pathogenic role of Corynebacterium urealyticum in the development of encrusted pyelitis (EP) and encrusted cystitis (EC), and their clinical consequences in renal transplant recipients. During a 4-year period, we studied seven renal transplant recipients with EP and two with EC. The records of 320 other renal transplant patients studied during the same period were used as a control group. C urealyticum (> or = 10(5) CFU/ml) was isolated from 4 patients with EP (urine 3, blood 1) and from 1 patient with EC (urine). Alkaline urines with struvite crystals, microscopic hematuria, and sterile conventional urine cultures were present in all our cases. All the patients with EP developed obstructive uropathy with deterioration of the renal function and pyelonephritis (4 patients) or renal abscesses (3 patients). Chronic urinary discomfort and macroscopic hematuria were present in the 2 patients with EC. Long-term vesical and ureteral catheterization were considered the most important risk factors for the development of EC and EP, respectively. Vancomycin was successfully used in 5 cases, but all the patients required a derivative procedure or a surgical resection of the incrustations to improve. We conclude that EP and EC should be investigated in renal transplant patients who develop pyelonephritis, obstructive uropathy, or chronic urinary symptoms. EP and EC could lead to the loss of their grafts. C urealyticum appears to have a pathogenic role in these entities.
Subject(s)
Corynebacterium Infections , Cystitis/microbiology , Kidney Transplantation/adverse effects , Pyelitis/microbiology , Adult , Cystitis/drug therapy , Cystitis/epidemiology , Female , Humans , Male , Middle Aged , Prospective Studies , Pyelitis/drug therapy , Pyelitis/epidemiology , Retrospective Studies , Vancomycin/therapeutic useABSTRACT
Emphysematous pyelitis is air in the renal collecting system in patients with urinary tract infections. This entity is uncommon and seen primarily in patients with diabetes mellitus. We report a case of a patient with end-stage renal disease treated with peritoneal dialysis who developed emphysematous pyelitis who presented with signs and symptoms that were more consistent with appendicitis. The spectrum of infections causing air in the urinary tract and the method by which end-stage renal disease patients are treated are discussed. Patients receiving dextrose peritoneal dialysis are at risk for emphysematous pyelonephritis, pyelitis, and cystitis.
Subject(s)
Abdomen, Acute/diagnosis , Emphysema/diagnosis , Kidney Failure, Chronic/therapy , Peritoneal Dialysis/adverse effects , Pyelitis/diagnosis , Diagnosis, Differential , Emphysema/drug therapy , Emphysema/etiology , Female , Humans , Kidney Failure, Chronic/complications , Middle Aged , Peritoneal Dialysis/methods , Pyelitis/drug therapy , Pyelitis/etiologyABSTRACT
The clinical applications of chemotherapy and antibiotic treatment are reviewed with specific reference to ceftazidime. The encouraging results obtained with this cephalosporin on a group of patients suffering from sepsis, higher and lower respiratory tract, biliary, bone and urinary tract infections are reported. The doctrinaire and practical use of this drug in single or multiple antibiotic treatment programmes is discussed.
Subject(s)
Bacterial Infections/drug therapy , Ceftazidime/therapeutic use , Ceftazidime/adverse effects , Cholangitis/drug therapy , Drug Tolerance , Female , Humans , Osteomyelitis/drug therapy , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Pyelitis/drug therapy , Respiratory Tract Infections/drug therapyABSTRACT
The therapeutic efficacy of cefoxitin was studied in 15 patients with pulmonary or urinary infections, after other unsuccessful antibiotic treatment. The drug determined a total regression of clinical picture within 10 days of therapy. Our results show that brief periods of treatment are sufficient in order to obtain recovery and to avoid selection of resistant germs. Patients treated with cefoxitin did not present any intolerance. The conclusion is drawn that "Mefoxin" is useful in patients affected by infections resistant to common antibiotics.
Subject(s)
Cefoxitin/therapeutic use , Abscess/drug therapy , Adult , Aged , Bronchitis/drug therapy , Bronchopneumonia/drug therapy , Buttocks , Clinical Trials as Topic , Drug Tolerance , Female , Humans , Klebsiella/drug effects , Male , Middle Aged , Pyelitis/drug therapy , Streptococcus/drug effectsABSTRACT
PURPOSE: Its described three cases of Corynebacterium urealyticum (CU) infection in patients with renal transplantation and one of its most serious consequences: encrusted pyelitis and cystitis. It is explained the principal keys for its diagnosis, based in the appearance of alkaline pH in in urine analysis (alkaline urine), positives urinary cultures for CU, and the CT and US studies revealed the characteristic images of calcifications in the wall of renal pelvis and bladder. PATIENTS: Three male patients with renal transplantation and CU infection that caused encrusted pyelitis in two of the cases and encrusted cystitis in one case. RESULTS: Calcifications of the urinary tract were noticed in CT in all the patients. In two cases bladder stones were linear, and in the third case they were fundamentally coarse and placed in pelvis. The diagnosis suspicion showed by the images was confirmed by the use of prolonged urine cultures, necessary for detecting CU. All the patients were treated with vancomycin, with success in two of the cases and, finally needing surgery, and after loss of the graft, in the other case. CONCLUSION: Encrusted pyelitis and cystitis are cronic and severe infections of the urinary tract. Calcic struvite incrustations in the urothelium are characteristics of this infection. CT is a choice technique for the diagnosis and followup of the calcifications after treatment.
Subject(s)
Corynebacterium Infections/diagnostic imaging , Corynebacterium/isolation & purification , Cystitis/diagnostic imaging , Kidney Transplantation/adverse effects , Pyelitis/diagnostic imaging , Adult , Anti-Bacterial Agents/therapeutic use , Corynebacterium Infections/drug therapy , Cystitis/drug therapy , Humans , Kidney/pathology , Kidney/surgery , Kidney Transplantation/diagnostic imaging , Male , Middle Aged , Pyelitis/drug therapy , Tomography, X-Ray Computed , Treatment Outcome , Ultrasonography , Vancomycin/therapeutic useABSTRACT
Presentation of a new case of unilateral cystic pyeloureteritis in a 46-year old female patient. The condition presented as a right renoureteral colic. A revision is made of the 69 national cases published on such an uncommon condition, of obscure etiologic, pathogenic and therapeutical features. The accent is placed on its most significant aspects, such as: difficulties of differential diagnosis with other repletion defect imagen in the excretory tract and their frequent association to other diseases.
Subject(s)
Cysts/diagnosis , Pyelitis/diagnosis , Ureteral Diseases/diagnosis , Cysts/drug therapy , Diagnosis, Differential , Drug Therapy, Combination , Female , Humans , Inflammation/diagnosis , Inflammation/drug therapy , Middle Aged , Pyelitis/drug therapy , Ureteral Diseases/drug therapyABSTRACT
Laboratory and clinical studies of cefamandole (CMD), a new semisynthetic cephalosporin, were investigated and following results were obtained. 1) Absorption and excretion study following 25 mg/kg intravenous administration was carried out in pediatric patients. In 6 cases, mean serum levels of 116.7 +/- 24.0 micrograms/ml, 62.1 +/- micrograms/ml, 12.2 +/- 2.7 micrograms/ml, 2.9 +/- 1.1 micrograms/ml, 0.6 +/- 0.6 micrograms/ml and 0.1 +/- 0.2 micrograms/ml obtained after 15, 30 minutes, 1, 2, 4 and 6 hours administration. In 4 cases, mean urinary recovery of 68.2 +/- 17.2% (0 approximately 8 hours) was obtained. The mean half life of serum level was 0.36 +/- 0.08 hours. 2) The transfer of cefamandole was poor in infants with meningitis. 3) Cefamandole was given to 22 children with acute pyelitis (1 case), acute pneumonia (19 cases), and meningitis (2 cases). The dosage was 80.0 approximately 284.2 mg/kg/day, and it was divided into 4 approximately 6 times and given intravenous or intravenous drip. The duration of administration was from 3 to 17 days. The overall efficacy rate in 22 cases was 95.2%, i.e., excellent in 5, good in 15, poor in 1, and unknown in 1. In bacteriological examination, there were eradication of the organisms in 9 (52.9%), decrease in 4, unchange in 4 out of 17 strains. 4) Any noticeable adverse reaction was not observed.
Subject(s)
Cefamandole/therapeutic use , Cephalosporins/therapeutic use , Adolescent , Cefamandole/metabolism , Child , Child, Preschool , Female , Humans , Infant , Male , Meningitis/drug therapy , Pneumonia/drug therapy , Pneumonia/metabolism , Pyelitis/drug therapyABSTRACT
Nine pediatric patients with moderate or severe bacterial infections (3 septicemia or bacteremia, 2 pyelitis, 2 tonsillitis, 1 pneumonia and 1 pyothorax) in hospital were treated with MK-0787/MK-0791. The drug was administered intravenously by 30 or 60 minutes drip infusion in 3 or 4 divided doses totalling 24 mg/24 mg-70.2 mg/70.2 mg per kg/day. Clinical effectiveness were excellent in 4 cases, good in 2 cases, poor in 2 cases and not evaluated in 1 case. The overall efficacy rate was 75%. A slight decrease of WBC was observed in 1 case. It was concluded that MK-0787/MK-0791 was a useful antibiotic for the treatment of infections in pediatric practices. Pharmacokinetics of intravenously administered MK-0787/MK-0791 was studied in 2 other cases. The MK-0787/MK-0791 was administered intravenously by 30 or 60 minutes drip infusion to 2 cases at a dose of 10 mg/10 mg/kg. The mean half-life (T1/2) of MK-0787 was 1.03 hours and MK-0791, 0.69 hour. The mean urinary recovery rate of MK-0787 within 6.5-7 hours after administration was 62.5% and MK-0791, 76.7%.
Subject(s)
Bacterial Infections/drug therapy , Cyclopropanes/administration & dosage , Thienamycins/administration & dosage , Adolescent , Child , Child, Preschool , Cilastatin , Drug Combinations , Empyema/drug therapy , Female , Humans , Imipenem , Infant , Infusions, Intravenous , Kinetics , Male , Pneumonia, Staphylococcal/drug therapy , Pyelitis/drug therapy , Sepsis/drug therapy , Tonsillitis/drug therapyABSTRACT
Cefoxitin was given to the 7 patients of infections in the field of obstetrics and gynecology, and the following results were obtained: 1) The clinical response was excellent in 2 patients, good in 4 and poor in 1 patient with the efficacy rate of 85.7%. Out of the 4 patients resistant to the previous therapy with other antibiotics, 3 patients responded to cefoxitin, and all the 3 patients of anaerobic infections responded satisfactorily to cefoxitin. 2) Microorganisms isolated were 2 strains each of E. coli and Staphylococcus aureus, 3 strains of Peptococcus and 1 strain of Eubacterium lentum. All the 8 strains isolated were sensitive to cefoxitin. As to bacteriological response, all the strains isolated were eradicated except 1 strain of Staphylococcus aureus which recurred on the 9th day after completion of the therapy with the eradication rate of 87.5%. 3) No subjective nor objective side effects were noted. Especially, the elevated GOT and GPT observed on a patient complicated with hepatitis prior to the initiation of cefoxitin treatment were found to be normal upon completion of the treatment.
Subject(s)
Cefoxitin/therapeutic use , Genital Diseases, Female/drug therapy , Abdominal Muscles , Adult , Aged , Cesarean Section/adverse effects , Female , Fistula/drug therapy , Fistula/etiology , Genital Diseases, Female/surgery , Humans , Middle Aged , Parametritis/drug therapy , Pelvic Inflammatory Disease/drug therapy , Postoperative Complications , Pregnancy , Pyelitis/drug therapy , Wound Infection/drug therapyABSTRACT
Ceftizoxime (CZX) was given in daily doses of 4 approximately 6 g by intravenous drip infusion to 30 patients with infection accompanying lung cancer to investigate the usefulness of the drug for infectious disease: The rate of effectiveness (marked and moderate) was 73.3% (22/30 patients). Of the 30 patients, 2 had drug fever; 1, arthralgia; and 1, eosinophilia. These side effects improved after the drug was withdrawn. CZX is a very useful antibiotic with high effectiveness and safety in immunocompromised patients with infection accompanying advanced lung cancer.
Subject(s)
Bacterial Infections/drug therapy , Cefotaxime/analogs & derivatives , Lung Neoplasms/complications , Adenoma/complications , Adult , Aged , Carcinoma, Small Cell/complications , Carcinoma, Squamous Cell/complications , Cefotaxime/adverse effects , Cefotaxime/therapeutic use , Ceftizoxime , Female , Fever/chemically induced , Humans , Male , Middle Aged , Pneumonia/drug therapy , Pyelitis/drug therapy , Respiratory Tract Infections/drug therapyABSTRACT
Ampicillin-cloxacillin (Rectocillin 'Kyowa') was administered either orally (capsules) or by intravenous drip infusion to a total of 40 patients and the following results were obtained: 1. Effectiveness obtained in the group received Rectocillin capsules (1,500 mg/day) was 80%. 2. Effectiveness obtained in the group received Rectocillin intravenous drip infusion (3 similar to 10 g/day) was 64.7%. 3. Side effects were encountered in 2 of 40 patients, but none of them were serious, and clinical abnormalities due to this antibiotic were not observed.
Subject(s)
Ampicillin/administration & dosage , Cloxacillin/administration & dosage , Urologic Diseases/drug therapy , Acute Disease , Administration, Oral , Adult , Ampicillin/therapeutic use , Capsules , Chronic Disease , Cloxacillin/therapeutic use , Cystitis/drug therapy , Drug Combinations , Drug Evaluation , Epididymitis/drug therapy , Female , Humans , Infusions, Parenteral , Male , Middle Aged , Prostatitis/drug therapy , Pyelitis/drug therapy , Surgical Wound Infection/prevention & control , Urethritis/drug therapyABSTRACT
The authors treated 30 patients (11 females and 19 males) with cystitis or cystopyelitis. Patients were randomly assigned to one of the following treatments: a) netilmicin 200 mg daily, b) netilmicin 200 mg + ampicillin 1 g daily. Clinical and bacteriologic results were positive in all cases with resolution of clinical signs of infection and negative cultures at the end of treatment. Netilmicin alone yielded the same results as its combination with ampicillin. The safety, monitored also with netilmicin serum levels, was always good.