Penicillin G-induced hemorrhagic cystitis with hydronephrosis.
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.
Toma
Yuichiro
Y
The Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan. asikaga@yahoo.co.jp
Ishiki
Tetsuya
T
Nagahama
Kazufumi
K
Okumura
Koichiro
K
Kamiyama
Tomomasa
T
Kohagura
Kentaro
K
Kakihana
Ayano
A
Tana
Takeshi
T
Ohya
Yusuke
Y
Takishita
Shuichi
S
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
D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein; D003401:Creatine; D010400:Penicillin G