title: Penicillin G-induced hemorrhagic cystitis with hydronephrosis.
abstract: Irritable urological symptoms with gross hematuria and bilateral lumbar pain developed when the patient received penicillin G for endocarditis. These symptoms were followed by renal insufficiency. A contrast-enhanced abdominal computed tomography (CT) scan revealed a thickened bladder wall, bilateral hydroureter and hydronephrosis, suggesting hemorrhagic cystitis complicated with urinary tract obstruction. Urine culture was negative. After discontinuation of penicillin G, all symptoms subsided and renal function recovered; hence, penicillin G seems to have been associated with hemorrhagic cystitis and acute kidney injury. Positive findings in the drug lymphocyte stimulation test (DLST) for penicillin G were consistent with this diagnosis.
authors.affiliation: The Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan. asikaga@yahoo.co.jp
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Toma
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ishiki
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Nagahama
authors.forename: Koichiro
authors.initials: K
authors.lastname: Okumura
authors.forename: Tomomasa
authors.initials: T
authors.lastname: Kamiyama
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kohagura
authors.forename: Ayano
authors.initials: A
authors.lastname: Kakihana
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tana
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ohya
authors.forename: Shuichi
authors.initials: S
authors.lastname: Takishita
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002097:C-Reactive Protein / Q000378:metabolism; D003401:Creatine / Q000097:blood; D003556:Cystitis / Q000139:chemically induced*; D004697:Endocarditis, Bacterial / Q000188:drug therapy; D006417:Hematuria / Q000139:chemically induced; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D006869:Hydronephrosis / Q000097:blood / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010400:Penicillin G / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014517:Ureteral Obstruction / Q000150:complications / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein; D003401:Creatine; D010400:Penicillin G