rifampin and Cystitis

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Urinary; Bacteriuria; Cephalosporins; Chloramphenicol; Culture Media; Cycloserine; Cystitis; Erythromycin; Escherichia coli Infections; Gentamicins; Hemagglutination Tests; Humans; Kanamycin; Methenamine; Methods; Nalidixic Acid; Nitrofurantoin; Penicillins; Polymyxins; Pseudomonas Infections; Pyelonephritis; Rifampin; Streptomycin; Sulfonamides; Tetracycline; Trimethoprim; Urinary Tract Infections

Topics: Administration, Oral; Adolescent; Adult; Aged; Ampicillin; Clinical Trials as Topic; Cystitis; Female; Humans; Kidney Failure, Chronic; Male; Microbial Sensitivity Tests; Middle Aged; Prostatitis; Pyelonephritis; Rifampin; Urethritis; Urinary Tract Infections

Tuberculosis (TB) is a multi-systemic disease instigated by Mycobacterium tuberculosis that can involve any organ. In any child presenting with clinical features involving multiple organ systems, TB forms an important differential. This holds particularly for endemic countries like India. Genitourinary TB (GUTB) comprises up to 27% of all extrapulmonary TB cases. We present an unusual presentation of disseminated TB involving kidneys and presenting as gross hematuria. 12-year-old girl, presented with recurrent episodes of gross hematuria of one-month duration. She received multiple packed cell transfusions for the same. She had chronic malnutrition. USG KUB with renal doppler was normal. Given persistent hematuria, CT urography was done which showed features suggestive of papillary necrosis with cystitis. Tubercular workup showed multiple opacities predominantly involving perihilar regions bilaterally on chest x-ray along with positive Mantoux test. Sputum for AFB was positive for tubercular bacilli. Urine samples were also sent for CBNAAT which showed TB bacilli sensitive to rifampicin. With a diagnosis of disseminated TB, antitubercular therapy (ATT) was started followed by cystoscopic resection of inflamed bladder wall tissue. Bladder mucosal biopsy confirmed caseating granulomas suggestive of tuberculous cystitis. The patient is doing well and symptom-free after completion of ATT.

Topics: Antibiotics, Antitubercular; Blood Transfusion; Child; Cystitis; Female; Hematuria; Humans; Kidney; Mycobacterium tuberculosis; Necrosis; Recurrence; Rifampin; Severity of Illness Index; Tomography, X-Ray Computed; Treatment Outcome; Tuberculosis, Urogenital; Urogenital System

Intravesical bacillus Calmette-Guerin (BCG) is widely used in the management of bladder cancer but because it is a living organism, local and disseminated infection may result.. A prospective assessment of complications of this therapy in 200 patients in Queensland was performed. A review of management of complications of intravesical BCG was also carried out.. Major side effects were rare. Cystitis was the most common side effect, being seen to some degree in all patients, although only forcing cessation of BCG therapy in two patients. Two patients developed persistent cystitis necessitating institution of isoniazid and rifampicin. Two patients had culture-proven bladder infection that presented several months after the BCG treatment. These patients also responded to two-drug antituberculous therapy. While low-grade fever is very common with this therapy, seven patients (3.5%) had fevers of > 39 degrees C within 48 h of receiving BCG. Fevers may be an indication of severe disseminated mycobacterial infection, which has a high mortality, so it needs to be treated aggressively. Alternatively bacterial sepsis with gram-negative bacterial pathogens or a hypersensitivity reaction to BCG may cause this degree of fever, and cannot be rapidly distinguished from fulminant mycobacterial infection. One patient in the present series developed pneumonia attributed to mycobacterial dissemination.. The key to appropriate management of complications of BCG therapy is awareness of their possibility, even months or years after the therapy has been given. Appropriate empirical therapy in acute situations and mycobacterial culture in chronic situations can then be performed.

Topics: Administration, Intravesical; Aged; Aged, 80 and over; Amoxicillin; Antitubercular Agents; BCG Vaccine; Carcinoma, Transitional Cell; Cystitis; Drug Therapy, Combination; Female; Fever; Gentamicins; Humans; Immunotherapy; Isoniazid; Male; Middle Aged; Prospective Studies; Rifampin; Urinary Bladder Neoplasms; Urinary Tract Infections

Urinary tuberculosis is a rare disease in children. It poses major diagnostic problems because of clinical symptoms, which are often atypical and misleading. It causes serious lesions which are often multifocal and extensive, requiring complex surgical excision and urinary tract reconstruction. Prevention of this disease is based on generalized vaccination with BCG and adequate treatment of pulmonary tuberculosis. The authors report a case of urinary tuberculosis in a fourteen-year-old child who presented episodes of cystitis and hematuria refractory to treatment. The diagnosis, confirmed by the positive test for AFB in the urine was established late, at the stage of silent kidney and scleroatrophic bladder. The patient was treated with antituberculous chemotherapy (Isoniazid; Rifampicin, PZA) and nephro-ureterectomy with augmentation enterocystoplasty.

Topics: Adolescent; Antitubercular Agents; Atrophy; Bacteriuria; BCG Vaccine; Child; Cystitis; Hematuria; Humans; Isoniazid; Male; Mycobacterium tuberculosis; Nephrectomy; Pyrazinamide; Rifampin; Sclerosis; Tuberculosis, Pulmonary; Tuberculosis, Renal; Tuberculosis, Urogenital; Ureter; Urinary Bladder; Urinary Bladder Diseases

The authors report a series of 40 cases of genitourinary tuberculosis diagnosed and treated in the department of urology "B" of Avicenne hospital over a 7-year period. The objective of this study is to define the various diagnostic and therapeutic aspects of this disease. The patients were predominantly males (62.5%) with a mean age of 40 years. 25% of cases reported a history of extra-urinary tuberculosis. The very polymorphous clinical presentation is dominated by signs of cystitis (45%). Intravenous urography is frequently suggestive of the diagnosis based on the appearance and multiplicity of the lesions. The radiological lesions most frequently encountered were silent kidney (19 cases) and small tuberculous bladder (11 cases). The definitive diagnosis was established by pathological examination in 38 cases (biopsies, operative specimens, prostatic resection chips) and/or by demonstration of AFB in 2 cases (urine, pus). Tuberculostatic treatment was administered to all patients, either alone (5 cases) or, more usually, in combination with surgical and/or endo-urological treatment (35 cases), reflecting the magnitude and severity of the destructive and scar lesions.

Topics: Adolescent; Adult; Aged; Antibiotics, Antitubercular; Antitubercular Agents; Biopsy; Combined Modality Therapy; Constriction, Pathologic; Cystitis; Female; Humans; Isoniazid; Male; Middle Aged; Mycobacterium tuberculosis; Nephrectomy; Prostatic Diseases; Pyrazinamide; Rifampin; Stents; Tuberculosis, Male Genital; Tuberculosis, Renal; Tuberculosis, Spinal; Tuberculosis, Urogenital; Ureteral Diseases; Urinary Bladder Diseases; Urography

Rifampicin (usually 600 mg per day, with ethambutol 1 gm or isoniazide) was given to 106 patients with tuberculosis: 6 during pregnancy, 4 of whom were taking estrogen and progestagens for hormonal imbalance , 14 women taking oral contraceptives or steroids, 25 women with increased estrogen levels, and 5 elderly women taking testosterone. Particular attention was paid to liver function considering reports of jaundice in pregnancy, oral contraception, and use of rifampicin with isoniazide. The 6 pregnancies resulted in 5 normal infants (1 with meconium staining) and 1 fetal death at 6 months. During pregnancy there were 3 incidents of elevated serum glutamic-pyruvate transaminase (SGPT) 30-150 units, and 1 of liver toxicity. The authors' concluded that there was no proof that rifampicin caused the hormonal imbalance or fetal death, and it can be prescribed safely, especially after the first 3 months. In 12 progestagen and estrogen users, there were 1 jaundice treated by stopping rifampicin but not the pill, and 4 incidents of elevated SGPT of 35-90 units. The authors recommended following those taking pills and rifampicin with regular SGPT tests. 5 patients received cyclofenil, 400 or 800 mg per day, in addition to rifampicin to induce ovulation or treat menopausal symptoms: this resulted in 1 case of hepatic toxicity. Cyclofenil is preferred over estrogen for treating menopausal symstoms in patients on rifampicin. 5 postmenopausal women received methyl-testosterone and ethinyl estradiol without any change in SGPT.

Topics: Adolescent; Adult; Antitubercular Agents; Chemical and Drug Induced Liver Injury; Contraceptives, Oral; Cystitis; Drug Resistance, Microbial; Female; Fetus; Humans; Infant; Infant, Newborn; Liver; Male; Menopause; Middle Aged; Pregnancy; Pregnancy Complications, Infectious; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Disease; Adolescent; Adult; Aged; Chronic Disease; Cystitis; Female; Humans; Male; Middle Aged; Prostatitis; Pyelitis; Pyelonephritis; Rifampin; Semen; Urinary Tract Infections