[Corynebacterium urealyticum in renal trasplantation. CT and sonography imaging characteristics of encrusted cistitis and pielitis].
OBJECTIVE
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.


METHODS
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.


CONCLUSIONS
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.
Servicio de Radiodiagnóstico, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia. vvs63@hotmail.com
V
V
Vázquez
M D
MD
Morales
C
C
Serrano
M
M
Reus
S
S
Llorente
J
J
García
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003352:Corynebacterium / Q000302:isolation & purification*; D003354:Corynebacterium Infections / Q000000981:diagnostic imaging* / Q000188:drug therapy; D003556:Cystitis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011702:Pyelitis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014640:Vancomycin