title: Recurrent obstructive acute pyelonephritis: A rare form of Actinotignum (Actinobaculum) schaalii infection in a HIV-1 infected patient.
abstract: Actinobaculum schaalii is a rarely reported, anaerobic, Gram-positive bacterium which role as uropathogen is emerging. We report here the case of a 47 year old HIV-1 infected woman presented with five recurrent episodes of obstructive pyelonephritis in the context of multiple renal stones. No bacteria was found until the fifth episode, during which prolonged urinary cultures as well as 16S rDNA sequencing allowed the diagnosis of A. schaalii infection. She had developed a life-threatening condition with severe renal failure. A right nephrectomy was performed and found that the intrarenal stones were attributed to the antiretroviral therapy. The renal parenchyma corresponded to an end-stage renal disease with chronic pyelonephritis without abcesses or granules. The situation improved after six months of amoxicillin therapy.
authors.affiliation: Assistance Publique Hôpitaux de Paris, Service de Médecine Interne et Immunologie Clinique, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Vallet
authors.affiliation: Assistance Publique Hôpitaux de Paris, Service de Médecine Interne et Immunologie Clinique, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France; Université Paris 11, Faculté de Médecine Paris Sud, Le Kremlin Bicêtre, France; CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, France; Inserm, U1184, Centre d'Immunologie des Maladies Virales et Autoimmunes, France. Electronic address: nicolas.noel@aphp.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Noël
authors.affiliation: Assistance Publique Hôpitaux de Paris, Service d'Urologie, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France.
authors.forename: Rachid
authors.initials: R
authors.lastname: Bahi
authors.affiliation: Assistance Publique Hôpitaux de Paris, Service de Médecine Interne et Immunologie Clinique, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France.
authors.forename: Elina
authors.initials: E
authors.lastname: Teicher
authors.affiliation: Assistance Publique Hôpitaux de Paris, Service de Médecine Interne et Immunologie Clinique, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France.
authors.forename: Yann
authors.initials: Y
authors.lastname: Quertainmont
authors.affiliation: Assistance Publique Hôpitaux de Paris, Service de Médecine Interne et Immunologie Clinique, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France; Université Paris 11, Faculté de Médecine Paris Sud, Le Kremlin Bicêtre, France; CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, France; Inserm, U1184, Centre d'Immunologie des Maladies Virales et Autoimmunes, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Delfraissy
authors.affiliation: Université Paris 11, Faculté de Médecine Paris Sud, Le Kremlin Bicêtre, France; Assistance Publique Hôpitaux de Paris, Service d'Anatomie et de Cytologie Pathologiques, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Ferlicot
authors.affiliation: Assistance Publique Hôpitaux de Paris, Service de Microbiologie, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Potron
authors.affiliation: Assistance Publique Hôpitaux de Paris, Service de Médecine Interne et Immunologie Clinique, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France; Université Paris 11, Faculté de Médecine Paris Sud, Le Kremlin Bicêtre, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Goujard
authors.affiliation: Assistance Publique Hôpitaux de Paris, Service de Médecine Interne et Immunologie Clinique, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France; Université Paris 11, Faculté de Médecine Paris Sud, Le Kremlin Bicêtre, France; CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, France; Inserm, U1184, Centre d'Immunologie des Maladies Virales et Autoimmunes, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lambotte
mesh_terms: D000191:Actinomycetaceae / Q000235:genetics / Q000302:isolation & purification*; D000193:Actinomycetales Infections / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D060085:Coinfection; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007668:Kidney / Q000473:pathology; D007669:Kidney Calculi; D008875:Middle Aged; D011704:Pyelonephritis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012008:Recurrence; D017422:Sequence Analysis, DNA
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S; D000658:Amoxicillin
keywords: Actinobaculum schaalii; HIV; Kidney stones; Obstructive urinary tract infection