Cases reported "Urinary Tract Infections"

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211/750. Community-acquired urinary tract infection caused by vancomycin-resistant enterococcus faecalis clinical isolate.

    We present a case of urinary tract infection caused by vancomycin-resistant enterococcus faecalis. The patient is a 62-year-old woman showing no recent admittances. The isolated microorganism was identified by MicroScan (DADE) and API (BioMerieux) and susceptibility was assessed by disk diffusion, E-test and broth microdilution. The isolate was identified as enterococcus faecalis and showed high MIC for vancomycin (>128 mg/l) and teicoplanin (8 mg/l) but was susceptible to ampicillin. The transmission routes of vancomycin-resistant enterococci in the community and their clinical implications remain uncertain. Healthy carriers have already been described in several countries but this case report represents an unusual finding. ( info)

212/750. Marked renal damage in a child with hydronephrosis infected by trichosporon asahii.

    We describe a case of urinary infection caused by trichosporon asahii, which drastically aggravated renal function in a left hydronephrotic kidney. Previous implantation of a nephrostomy tube and a ureteral J-stent and administration of broad-spectrum antibiotics seemed to have predisposed the non-granulocytopenic child to the urinary fungal infection. ( info)

213/750. lactobacillus sepsis associated with probiotic therapy.

    Probiotic strains of lactobacilli are increasingly being used in clinical practice because of their many health benefits. Infections associated with probiotic strains of lactobacilli are extremely rare. We describe 2 patients who received probiotic lactobacilli and subsequently developed bacteremia and sepsis attributable to lactobacillus species. Molecular dna fingerprinting analysis showed that the lactobacillus strain isolated from blood samples was indistinguishable from the probiotic strain ingested by the patients. This report indicates, for the first time, that invasive disease can be associated with probiotic lactobacilli. This report should not discourage the appropriate use of lactobacillus or other probiotic agents but should serve as a reminder that these agents can cause invasive disease in certain populations. ( info)

214/750. Cake kidney drained by single ureter.

    Cake kidney is a rare congenital anomaly of the urogenital tract, with a few more than 20 cases described in the literature. It can be diagnosed at any age range. Normally, drainage is achieved by 2 ureters, and there are only 5 reports in the literature of cake kidney drained by a single ureter. The authors describe one more case of this rare malformation of the urinary tract. ( info)

215/750. Recurrent infection stones with apparently negative cultures. The case for blind antibacterial treatment.

    Infection stones in the urinary tract are always associated with infection with a urease-producing, urea-splitting organism. The most common of these organisms are easy to culture and identify and can be treated early either with an appropriate antibiotic or with an anti-urease agent. ureaplasma urealyticum and corynebacterium urealyticum are urease-producing organisms which are difficult to grow; their presence and effects frequently go undetected and untreated. Other organisms, as yet unknown, may also be involved in the same process. We report the first series of 8 patients with recurrent infection-type stones likely to have been caused by a "hard to grow" organism. Five patients never had a positive culture; in 2 patients 1 of 10 urine cultures grew a coagulase-negative staphylococcus and in 1 patient the same organism was grown from a stone but never in the urine. The clinical course of all of these patients was significantly improved after blind treatment with antibiotics and in one case with an anti-urease agent. ( info)

216/750. Rapidly advancing invasive endomyocardial aspergillosis.

    The exposure to aspergillus organisms/spores is likely common, but disease caused by tissue invasion with these fungi is uncommon and occurs primarily in the setting of immunosuppression. We report a case of rapidly advancing invasive endomyocardial aspergillosis secondary to prolonged usage of multiple broad-spectrum antibiotics in a nonimmunocompromised host. A 36-year-old cotton textile worker presented to our institution with a 3-month history of weight loss and fatigue. He reported receiving prolonged use of multiple broad-spectrum antibiotic treatment. The echocardiogram demonstrated multiple endomyocardial vegetations and a mass in the left atrium. Myocardial biopsy specimen revealed an invasive endomyocardial aspergillosis. The patient was investigated for immune deficiency including hiv, and this workup was negative. Treatment was started with amphotericin b and heparin for presumed left atrial thrombus. The patient died because of a rupture of mycotic aneurysm that resulted in cerebral hemorrhage. This case illustrates the risk of an invasive fungal infection in a nonimmunocompromised host who is a prolonged user of antibiotics in the setting of environmental exposure of opportunistic invasive fungal infections. ( info)

217/750. Laparoscopic retroperitoneal resection of blind-ending bifid ureter in patient with recurrent urinary tract infections.

    Blind-ending bifid ureters are rare congenital anomalies. Symptomatic patients require surgical resection of the blind-ending ureter. Traditionally, open resection of the blind-ending segment has been performed. We describe a laparoscopic retroperitoneal three-port approach for resection of blind-ending bifid ureters. We believe this is a viable and less-invasive alternative to traditional open surgical resection of a blind-ending segment. ( info)

218/750. Urinary tract infection due to salmonella stanleyville in an otherwise healthy child.

    A healthy four-year-old boy developed a febrile urinary tract infection (UTI) due to salmonella stanleyville. The UTI developed following an episode of enteritis due to the same organism. salmonella UTI is uncommon and is reported more often in patients with a predisposing factor, such as immune deficiency or a structural abnormality, in the urinary tract. salmonella stanleyville has not been previously reported as a cause of UTI. ( info)

219/750. Urethral polyp in a 1-month-old child.

    Urethral polyps are a rare finding in children, particularly in the very young. They are suspected by the presence of various clinical signs such as obstruction, voiding dysfunction and haematuria. There is an association with other urinary tract congenital anomalies. They are usually benign fibro-epithelial lesions with no tendency to recur and are treated by surgical ablation, fulguration or laser therapy. We report a 1-month-old boy with an antenatally diagnosed left ectopic pelvic kidney, postnatal urinary tract infection and no clinical signs of obstruction. Voiding cystourethrography to exclude vesico-ureteric reflux showed a trabeculated bladder and a mobile filling defect in the posterior urethra. Owing to its large size, cystotomy was necessary to remove the polyp successfully. ( info)

220/750. Recurrent urinary tract infection due to hernia mesh erosion into the bladder.

    We present a rare cause of recurrent urinary tract infection and calculus formation: erosion of a mesh after an inguinal repair into the bladder of a 77-year-old male. ( info)
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