Successful treatment of Corynebacterium urealyticum encrusted cystitis: a case report and literature review.
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.
Pierciaccante
Antonio
A
Servizio di Consulenze Internistico-Infettivologiche, III Clinica Medica, Dipartimento di Medicina Clinica, Policlinico Umberto I. Università di Roma La Sapienza, Rome, Italy.
Pompeo
Maria Elena
ME
Fabi
Flavia
F
Venditti
Mario
M
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001031:Apatites / Q000032:analysis; D001426:Bacterial Proteins / Q000378:metabolism; D011232:Chemical Precipitation; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003352:Corynebacterium / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification / Q000378:metabolism; D003354:Corynebacterium Infections / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism / Q000601:surgery; D003460:Crystallization; D003556:Cystitis / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism / Q000382:microbiology / Q000601:surgery; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology / Q000601:surgery; D016867:Immunocompromised Host; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D017616:Magnesium Compounds / Q000032:analysis; D008297:Male; D009403:Nephrostomy, Percutaneous; D010710:Phosphates / Q000032:analysis; D011702:Pyelitis / Q000188:drug therapy / Q000382:microbiology; D012074:Remission Induction; D015607:Stents; D000069877:Struvite; D017334:Teicoplanin / Q000627:therapeutic use; D014510:Urease / Q000378:metabolism
D000900:Anti-Bacterial Agents; D001031:Apatites; D001426:Bacterial Proteins; D017616:Magnesium Compounds; D010710:Phosphates; C030782:carboapatite; D017334:Teicoplanin; D000069877:Struvite; D014510:Urease