1/7. Emphysematous cystitis in a patient presenting with paradoxical arterial embolism and intestinal mycobacteriosis without evidence of diabetes.We describe the case of a 72-year-old woman who displayed massive multiple intramural gas collections of the bladder wall as an incidental finding on CT. The patient presented with critical ischemia of the left leg caused by paradoxical arterial embolism, raised corpuscular sedimentation rate, anemia by gastrointestinal blood loss, hypoproteinemia, diarrhea, malabsorption, and exudative enteropathia caused by mycobacterial ileocolitis. The patient had no dysuria and there was no evidence of diabetes. The intramural gas collections of the bladder wall, as shown by CT, were compatible with emphysematous cystitis. urine samples proved infection by a multi-resistant strain of E. coli. Emphysematous cystitis is a rare form of bladder infection that can be diagnosed by plain-film radiograms or CT.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
2/7. Cidofovir treatment of human polyomavirus-associated acute haemorrhagic cystitis.We report the case of an 18-year-old patient who received an allogeneic bone marrow transplant from an HLA-identical unrelated donor for a Ph acute lymphoblastic leukemia, in his third complete remission. cyclophosphamide and busulfan were used as conditioning treatment. Acute graft-versus-host disease developed on day 9, and the response to adequate treatment (steroids) was favourable. On day 45 the patient developed an acute severe haemorhragic cystitis, and BK polyomavirus was demonstrated in urine samples using electron microscopy and polymerase chain reaction. Urinary symptoms did not improve in spite of palliative treatment, but a response was evident after 2 weeks of cidofovir treatment.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
3/7. Quantification of polyoma BK viruria in hemorrhagic cystitis complicating bone marrow transplantation.Polyoma bk virus (BKV) is frequently identified in the urine of bone marrow transplantation (BMT) patients with hemorrhagic cystitis (HC). However, viruria is common even in asymptomatic patients, making a direct causative role of BKV difficult to establish. This study prospectively quantified BK viruria and viremia in 50 BMT patients to define the quantitative relationship of BKV reactivation with HC. Adenovirus (ADV) was similarly quantified as a control. More than 800 patient samples were quantified for BKV VP1 gene with a real-time quantitative polymerase chain reaction. Twenty patients (40%) developed HC, 6 with gross hematuria (HC grade 2 or higher) and 14 with microscopic hematuria (HC grade 1). When compared with asymptomatic patients, patients with HC had significantly higher peak BK viruria (6 x 10(12) versus 5.7 x 10(7) genome copies/d, P <.001) and larger total amounts of BKV excreted during BMT (4.9 x 10(13) versus 7.7 x 10(8) genome copies, P <.001). There was no detectable increase in BK viremia. Binary logistic regression analysis showed that BK viruria was the only risk factor, with HC not related to age, conditioning regimen, type of BMT, and graft-versus-host disease. Furthermore, the levels of ADV viruria in patients with or without HC were similar and comparable with those of BK viruria in patients without HC, suggesting that the significant increase in BK viruria in HC patients was not due to background viral reactivation or damage to the urothelium. BK viruria was quantitatively related to the occurrence of HC after BMT.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
4/7. urinary tract infection caused by corynebacterium group D2: report of 82 cases and review.corynebacterium group D2 (CGD2) is a slow-growing, urea-splitting, multiantibiotic-resistant microorganism that is frequently isolated from urine samples and that, in certain circumstances, produces infection of the lower urinary tract (acute and chronic cystitis) and the upper urinary tract (pyelonephritis). This paper analyzes (by means of a retrospective and partially prospective clinical protocol) our experience with 82 patients with CGD2 bacteriuria. The infection was symptomatic in 62% of cases, and the clinical diagnoses included acute and chronic cystitis and pyelonephritis with or without bacteremia. Because CGD2 infection of the urinary tract may require specific antimicrobial treatment and because CGD2 is a fastidious microorganism, we recommend prolonged incubation of urine cultures (up to 48-72 hours), especially if the routine culture is negative, when patients are symptomatic, have alkaline urine, or have struvite crystals in the urine sediment.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
5/7. Mast cell activation in sterile bladder and prostate inflammation.Sterile inflammation of the bladder has often been associated with interstitial cystitis (IC), a urologic condition of unknown etiology, predominantly affecting young and middle-aged females, for which no effective therapy is known. Recent reports have indicated that IC is associated with an increased number of bladder mast cells. Here we report the case of a middle-aged man with chronic sterile hematuria, dysuria and lower abdominal pain associated with a high number of bladder and prostate mast cells. Following therapeutic transurethral resection of the trigone area, bladder neck and prostate, samples of bladder and prostate were examined with light and electron microscopy and contained many mast cells (about 150 cells/mm2) which were not degranulated. Nevertheless, mast cells contained many altered granules and urinary levels of histamine were elevated, implying secretion without exocytosis. These findings are discussed in the context of the pathophysiology of IC and possible therapeutic interventions.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
6/7. Presence of human polyomavirus dna in the peripheral circulation of bone marrow transplant patients with and without hemorrhagic cystitis.In BMT patients, shedding of bk virus (BKV) in the urine has been strongly but not absolutely correlated to hemorrhagic cystitis (HC). The possible presence of human polyomaviruses in peripheral blood leukocytes (PBLs), plasma, serum and urine in BMT patients and an association with HC was investigated by a nested PCR assay. Samples from allogeneic BMT patients with and without HC as well as from autologous BMT patients were analyzed. Human polyomaviruses were detected in urine and blood samples of both allogeneic and autologous BMT patients with and without HC. An association between the presence of a specific human polyomavirus in blood and HC was thus not observed.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
7/7. PCR detection of adenovirus in a bone marrow transplant recipient: hemorrhagic cystitis as a presenting manifestation of disseminated disease.Adenoviruses (AdV), causing fatal disseminated infections in bone marrow transplant (BMT) recipients, are associated not only with hemorrhagic cystitis (HC) but also with hepatitis, conjunctivitis, and viral interstitial pneumonia. The importance of this virus as a cause of disseminated disease, however, has remained underappreciated. AdV infection has been diagnosed primarily through the use of cell culture. The fact that cell culture is insensitive for detecting this virus has hindered recognition of the role that AdV may play in morbidity and mortality in BMT recipients. To emphasize these points, we describe a patient who presented with HC due to AdV serotype 11, genotype c, and died with disseminated infection. In addition to cell culture, this study used a newly developed PCR-based method, capable of detecting all AdV serotypes tested, including different genotypes of serotype 11. The PCR result was positive in all culture-positive samples, including samples of urine, conjunctiva, and bronchoalveolar lavage (BAL). Importantly, the PCR method provided evidence of urinary shedding of AdV in a pretransplant, culture-negative specimen and showed dissemination in a subset of culture-negative specimens, including BAL, blood, and bone marrow samples. The lack of widespread awareness of the fact that localized infections may presage dissemination, and the previous associated lack of rapid, sensitive diagnostic assays, has impaired recognition of AdV infections in patients undergoing BMT. Early detection may contribute to therapy modification and avoidance of unwarranted diagnostic procedures. It may also assist in epidemiologic control of this highly infectious pathogen and lead to a renewed interest in preventive and therapeutic approaches.- - - - - - - - - - ranking = 3keywords = sample (Clic here for more details about this article) |