[Encrusted pyelitis in patients with urinary diversion].
OBJECTIVE
This is a case of Encrusted Pyelitis (EP) caused by Corynebacterium urealyticum (CU) in a patient who had undergone a cystectomy and Bricker type urinary diversion 28 months beforehand.


RESULTS
After the immediate post-operative period no urinary catheterisation or any other urological procedure was performed on the patient. Before surgery, the patient presented non functional of the right kidney, secondary to a lithiasic obstructive uropathy. Clinical symptoms were deteriorated renal function, anuria, haematuria, pyrexia and left lumbar pain. It was suspected that the patient had this pathology and this was fundamental in diagnosis. Helicoid CT was the principal method used to show calcification plaques on the wall of the left renal pelvis, and selective culture of CU confirmed the diagnosis. Early commencement of treatment with vancomycin at an initial dosage of 500 mg/12 hours, and subsequent adjustment of dosage according to blood drug levels, achieved negative urine culture within a fortnight. Oral acidification was effected using acetohidroxamic acid 125 mg/12 hours, and it was continued until CT confirmed the disappearance or considerable reduction of the pyelic calcification plaques.


CONCLUSIONS
The presence of EP in patients with urinary diversion is a matter worthy of consideration, even in patients who have not undergone recent urological procedures. Awareness of risk factors and early commencement of effective treatment may improve the prognosis of these patients.
Martínez Silva
Victor Manuel
VM
Servicio de Urología, Hospital 12 de Octubre, Madrid, España. vmartinezsilva@terra.es
Villacampa Aubá
Felipe
F
Tejido Sánchez
Angel
A
Martín Muñoz
Manuel Pablo
MP
Cruceyra Betriú
Guillermo
G
Rosino Sánchez
Antonio
A
Leiva Galvis
Oscar
O
D000368:Aged; D002114:Calcinosis / Q000382:microbiology*; D003354:Corynebacterium Infections / Q000209:etiology*; D006801:Humans; D007674:Kidney Diseases / Q000382:microbiology; D007682:Kidney Pelvis; D008297:Male; D011702:Pyelitis / Q000382:microbiology*; D014547:Urinary Diversion / Q000009:adverse effects*
Pielitis incrustante en pacientes con derivación urinaria.