scholarly journals Emphysematous Cystitis: Report of an Atypical Case

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Karen De Baets ◽  
Joost Baert ◽  
Luc Coene ◽  
Marc Claessens ◽  
Robert Hente ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Rapid Progression ◽  
Emphysematous Pyelonephritis ◽  
Bladder Drainage ◽  
Atypical Case ◽  
Emphysematous Cystitis ◽  
Bladder Necrosis ◽  
Overall Mortality

We report the atypical case of a nondiabetic 66-year old male with severe abdominal pain and vomiting who was found to have emphysematous cystitis. Of all gas-forming infections of the urinary tract emphysematous cystitis is the most common and the least severe. The major risk factors are diabetes mellitus and urinary tract obstruction. Most frequent causative pathogens areEscherichia coliandKlebsiella pneumoniae. The clinical presentation is nonspecific and ranges from asymptomatic urinary tract infection to urosepsis and septic shock. The diagnosis is made by abdominal imaging. Treatment consists of broad-spectrum antibiotics, bladder drainage, and management of the risk factors. Surgery is reserved for severe cases. Overall mortality rate of emphysematous cystitis is 7%. Immediate diagnosis and treatment is necessary because of the rapid progression to bladder necrosis, emphysematous pyelonephritis, urosepsis, and possibly fatal evolution.

scholarly journals Bilateral Psoas Muscle Abscess Associated with Emphysematous Cystitis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Jae-Ki Choi ◽  
Jae-Cheol Kwon
Keyword(s):  
Urinary Tract ◽  
Early Recognition ◽  
Interventional Procedure ◽  
Psoas Muscle ◽  
Good Prognosis ◽  
Emphysematous Pyelonephritis ◽  
Perinephric Abscess ◽  
Emphysematous Cystitis ◽  
Tract Infections ◽  
Prolonged Antibiotic Therapy

Psoas muscle abscess associated with emphysematous urinary tract infection is very rare. There were very few reports about urinary tract infections such as renal abscess, perinephric abscess, and emphysematous pyelonephritis complicated with psoas muscle abscess; however, psoas muscle abscess associated with emphysematous cystitis has not yet been reported. Here, we report a case of bilateral posas muscle abscess following emphysematous cystitis in an 81-year-old nondiabetic man, who was treated successfully with prolonged antibiotic therapy and supportive care. Early recognition of psoas muscle abscess can prevent aggressive interventional procedure and warrant good prognosis.

Upper urinary tract infection

2015 ◽  
Author(s):  
Mark Harber
Keyword(s):  
Urinary Tract ◽  
Acute Pyelonephritis ◽  
Urinary Tract Obstruction ◽  
Reflux Nephropathy ◽  
Upper Urinary Tract ◽  
Chronic Pyelonephritis ◽  
Severe Illness ◽  
Emphysematous Pyelonephritis ◽  
Suppurative Infection

Pyelonephritis is a suppurative infection of the kidney most commonly due to bacterial infection that may be either acute or chronic. Acute pyelonephritis is usefully subdivided into uncomplicated and complicated. The term complicated pyelonephritis is associated with an abnormal urinary tract, obstruction, stones, immunocompromise, diabetes, pregnancy, or in practical terms any pyelonephritis resulting in severe illness. The distinction is important principally in terms of type, duration, and place of treatment.The clinical spectrum of acute pyelonephritis ranges from relatively mild illness to pyonephrosis and emphysematous pyelonephritis with a fulminant course and high mortality.The term chronic pyelonephritis has been used to describe kidneys damaged from multiple, recurrent, or partially treated episodes of infection, but for many of these examples ‘reflux nephropathy’ is a better description as the role of infection is not always clear. However chronic or very recurrent infections may be associated with diabetes, abnormal urinary tracts, and any cause of obstructed drainage. Chronic pyelonephritis is also an accurate description for the progressive ongoing destruction of the kidney that occurs in xanthogranulomatous pyelonephritis or malakoplakia.

scholarly journals Emphysematous cystitis: mortality, risk factors, and pathogens of a rare disease

2017 ◽  
Vol 7 (2) ◽  
Author(s):  
Andreas Schicho ◽  
Christian Stroszczynski ◽  
Philipp Wiggermann
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Mortality Rate ◽  
Mortality Risk ◽  
Conservative Management ◽  
Mortality Rates ◽  
Emphysematous Pyelonephritis ◽  
Emphysematous Cystitis ◽  
The Mean ◽  
High Degree

Although high mortality rates have been reported for emphysematous pyelonephritis (EP), information on emphysematous cystitis (EC), which is less common, is sparse. Here, we report one new case of severe EC and 136 cases of EC that occurred between 2007 and 2016, and review information about the characteristics, diagnosis, treatment and mortality of these patients, and the pathogens found in these patients. The mean age of the 136 patients was 67.9±14.2 years. Concurrent emphysematous infections of other organs were found in 21 patients (15.4%), with emphysematous pyelonephritis being the most common of these infections. The primary pathogen identified was <em>Escherichia coli</em> (54.4%). Patients were mainly treated by conservative management that included antibiotics (n=105; 77.2%). Ten of the 136 patients with EC died, yielding a mortality rate of 7.4%. Despite the relatively low mortality rate of EC compared with that of EP, a high degree of suspicion must be maintained to facilitate successful and conservative management.

scholarly journals Long-term urological complications after conservative local treatment (surgery and brachytherapy) in children with bladder-prostate rhabdomyosarcoma. A single team experience.

2021 ◽  
Author(s):  
Rezkalla Akkary ◽  
Cyrus Chargari ◽  
Florent Guérin ◽  
Loic Jochault ◽  
Georges Audry ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Bladder Wall ◽  
Local Treatment ◽  
Conservative Surgery ◽  
Urinary Lithiasis ◽  
Urological Complications

Background: Outcome of children with bladder-prostate rhabdomyosarcoma has improved with multimodal therapies, including surgery and/or radiotherapy for local treatment. Our aim was to report the long-term urological complications after a conservative approach combining conservative surgery and brachytherapy. Patients and methods: Eighty-six patients, free of disease, were retrospectively reviewed. Symptoms related to urinary tract obstruction, incontinence, infection and lithiasis were reported and graded according to CTCAE classification. Only symptomatic patients underwent urodynamic studies. Risk factors for complications were analyzed. Results: There were 76 males and 10 females. The median follow-up was 6.3 years (18 months-24 years). Complications occurred after a median follow up 5 years (0-21). Twenty-two patients had long-term urological complications. Urinary tract obstruction was found in 15 patients, urinary incontinence in 14 patients. Recurrent urinary tract infection and urinary lithiasis were found in 5 patients respectively. Beyond symptom, 3 etiologies were identified: bladder dysfunction in 15 patients, urethral stenosis in 6 and uretero-vesical junction stenosis in 5. Posterior bladder wall dissection used in large prostatic tumors, operation at age less than 2 years and partial prostatectomy were identified as risk factors for these complications. Conclusion: The conservative surgical approach combined with brachytherapy for BPRMS leads to long-term urological complications in 22% of patients free of their disease. Optimizing brachytherapy doses for young children and establishing a clear and long term follow-up protocol, could help to reduce these complications.

scholarly journals Clinical Outcomes and Risk Factor Analysis of Patients Presenting with Emphysematous Cystitis: A 15-Year Retrospective Multicenter Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 531
Author(s):  
Jeonghyouk Choi ◽  
Seung-Kwon Choi ◽  
Sang-Hyub Lee ◽  
Koo-Han Yoo
Keyword(s):  
Risk Factors ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Control Group ◽  
Emphysematous Pyelonephritis ◽  
Acute Cystitis ◽  
Emphysematous Cystitis ◽  
Patient Status ◽  
History Of ◽  
Retrospective Multicenter Study

Background and objectives: To investigate the risk factors for emphysematous cystitis (EC) compared to those of acute cystitis (AC) to increase clinicians awareness of the possibility for the aggravation of patient status. Materials and methods: We retrospectively reviewed a total of 54 patients who were hospitalized with a diagnosis of EC by abdominal computed tomography (CT) scan from 2006 to 2020. The control group included 92 patients who were hospitalized for the treatment of AC in the same period. We sought to identify the clinical features and predisposing diseases, such as age, sex, diabetes mellitus (DM), hypertension (HTN), cerebrovascular accident (CVA), chronic kidney disease (CKD), neurogenic bladder (NB), history of urinary tract infection (UTI), and emphysematous pyelonephritis (EPN), that were associated with the development of EC. Results: The median (interquartile range (IQR)) age of the patients with EC was older than that of the patients with AC (78.5 (15.3) years (range: 52–100) vs. 70.0 (26.5) years (range: 28–97 years)). Sepsis and mortality occurred only in the EC group (48.1% and 11.1%, respectively). The univariate analysis of predisposing factors revealed that age, DM, HTN, CVA, CKD, and NB were significantly associated with EC. In the multivariate analysis, DM (OR, 6.251; 95% CI, 2.254–17.250; p < 0.001), CKD (OR, 18.439; 95% CI, 3.421–99.404; p = 0.001), NB (OR, 7.374; 95% CI, 1.993–27.285; p = 0.003) were associated with EC. Conclusions: The results of this study revealed that DM, CKD, and NB were significant risk factors for EC. The tendency toward sepsis and high mortality underscore the need for careful observation while treating patients with EC with the risk noted above.

scholarly journals Emphysematous Pyelonephritis and Cystitis: Unusual Adverse Events during Concurrent Chemoradiotherapy for Lung Cancer

2017 ◽  
Vol 10 (1) ◽  
pp. 239-243 ◽  
Author(s):  
Tetsuya Yokoyama ◽  
Seiji Shinozaki ◽  
Hidenobu Arimura ◽  
Keita Nakatomi ◽  
Hiroshi Wataya
Keyword(s):  
Lung Cancer ◽  
Urinary Tract ◽  
Adverse Events ◽  
Concurrent Chemoradiotherapy ◽  
Urinary Tract Obstruction ◽  
Diabetic Woman ◽  
Emphysematous Pyelonephritis ◽  
Serious Infection ◽  
Potential Development ◽  
Risk Patients

Various adverse events can occur during antineoplastic therapy. A 67-year-old diabetic woman developed an emphysematous urinary tract infection (UTI) associated with chemoradiotherapy for lung cancer. She had received weekly carboplatin plus paclitaxel with thoracic radiotherapy and developed a fever on day 19. Computed tomography showed a large quantity of gas within the urinary tract. She was therefore diagnosed with emphysematous UTI. Poor diabetes control due to the weekly administration of dexamethasone, an existing urinary tract obstruction, and bone marrow suppression were involved in her serious infection. The potential development of emphysematous UTI during chemoradiotherapy should be considered in at-risk patients.

scholarly journals Acute Kidney Injury in Children with Kidney Transplantation

2018 ◽  
Vol 13 (11) ◽  
pp. 1721-1729 ◽  
Author(s):  
Omar Alkandari ◽  
Lieuko Nguyen ◽  
Diane Hebert ◽  
Valerie Langlois ◽  
Natasha A. Jawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Urinary Tract ◽  
Serum Creatinine ◽  
Urinary Tract Infections ◽  
Graft Loss ◽  
Rapid Progression ◽  
Kidney Transplant Recipients ◽  
Ckd Stage ◽  
Tract Infections

Background and objectivesAKI is associated with progression of CKD. Little is known about AKI after kidney transplantation in pediatric recipients. We aim to describe the epidemiology, risk factors, consequences, and outcomes of AKI in this population.Design, setting, participants, & measurementsWe performed a retrospective longitudinal analysis of pediatric kidney transplant recipients followed at The Hospital for Sick Children (Toronto, Canada) from 2001 to 2012. AKI was defined as an increase in serum creatinine ≥1.5 times baseline, and a rise of serum creatinine ≥1.25 but <1.5 times baseline defined subacute AKI.ResultsOf 179 children, 122 were eligible for analysis. At baseline (3 months post-transplant), median age of the children was 13 years old (interquartile range, 9–16 years old), and 53% had CKD stage 2. Congenital anomalies of the kidney and urinary tract accounted for 46% of children. Over the study period (12 years), the incidence of AKI was 37% (n=45 children), and 65% (79 children) experienced subacute AKI. Twenty-seven percent (33 children) did not develop AKI or subacute AKI. The main causes of AKI were infections other than urinary tract infections, rejection, and urinary tract infections. In a multivariable Poisson regression analysis, independent risk factors for AKI included younger age, girls, grafts from deceased donors, and lower baseline eGFR. AKI was significantly associated with lower long-term GFR and graft loss independent of rejection episodes. Moreover, subacute AKI was associated with progression of CKD.ConclusionsAKI and subacute AKI were common after pediatric kidney transplantation, and they were associated with graft loss, lower eGFR, and more rapid progression of CKD.

scholarly journals Utility of the blood culture in infection of the urinary tract with fever in the elderly

2021 ◽  
Author(s):  
Elisa Álvarez Artero ◽  
Amaia Campo Núñez ◽  
Moisés Garcia Bravo ◽  
Inmaculada García García ◽  
Moncef Belhassen Garcia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urine Culture ◽  
Urinary Infection ◽  
The Elderly ◽  
Blood Cultures ◽  
Febrile Urinary Tract Infection ◽  
Urinary Infections ◽  
Tract Infections ◽  
Overall Mortality

Introduction. Urinary tract infections are one of the most common community infections. The diagnosis of urinary infections in the elderly is complex because of its presentation and clinic. The aim of this article is to evaluate the usefulness of blood cultures in febrile urinary tract infection in elderly patients, risk factors, causes of discordance between urine and blood cultures, usefulness of biomarkers and mortality. Material and methods. Observational study of patients admitted over 65 years old, with urinary infections. Results. A total of 216 episodes with urinary infections and blood cultures performed. 70 (32,4%) cases with bacteremia. The most frequently detected isolates in blood cultures were: Escherichia coli 50 (71,4%) and Proteus spp. 6 (8,5%). Only septic shock was associated with a higher frequency of bacteraemia (OR=2,93, IC 95: 1,0-8,5; p=0,04). In 26 of the blood cultures a different isolation of the urine culture was detected. Overall mortality was 9.1%, with no association with the presence of bacteremia (p>0. 05). Conclusions. One third of elderly people hospitalized by tract urinary infection had bacteremia. Their detection was not associated with overall mortality. Disagree between blood and urine cultures in febrile is frequent, especially in patients with recent antibiotic treatment or recently hospitalized.

Prenatal Bladder Drainage in the Management of Fetal Lower Urinary Tract Obstruction

2003 ◽  
Vol 102 (2) ◽  
pp. 367-382 ◽  
Author(s):  
T. Justin Clark ◽  
William L. Martin ◽  
T. G. Divakaran ◽  
Martin J. Whittle ◽  
Mark D. Kilby ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Bladder Drainage ◽  
Lower Urinary Tract Obstruction ◽  
Lower Urinary
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