rifampin and Dysuria

We present an interesting case of Legionnaires' disease masquerading as acute pyelonephritis, with complete absence of respiratory symptoms on admission. A 45-year-old man was diagnosed with Legionnaires' disease 2 days after presenting to hospital with dysuria and right loin pain. He became critically unwell during the hospital admission, with headache, uncontrolled fever, breathlessness, decreasing oxygen saturations and increasing oxygen requirements. A CT pulmonary angiography demonstrated right upper lobar consolidation and Legionella urinary antigen was positive. He was treated with ciprofloxacin and rifampicin and made a full recovery.

Topics: Anti-Bacterial Agents; Antigens, Bacterial; Ciprofloxacin; Community-Acquired Infections; Diagnosis, Differential; Dysuria; Flank Pain; Humans; Legionnaires' Disease; Male; Middle Aged; Pneumonia; Pyelonephritis; Rifampin

Topics: Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; Chest Pain; Confusion; Cough; Diagnosis, Differential; Dyspnea; Dysuria; Female; Floxacillin; Humans; Methicillin-Resistant Staphylococcus aureus; Rifampin; Risk Factors; Staphylococcal Infections; Treatment Outcome

Dysuria is a very common symptom, which is taken lightly. It can lead to a diagnosis of disseminated Koch's, which if identified early can prevent permanent sequelae.

Topics: Adult; Antitubercular Agents; Drug Therapy, Combination; Dysuria; Ethambutol; Female; Humans; Isoniazid; Pyrazinamide; Rifampin; Tuberculosis, Female Genital; Tuberculosis, Renal; Urine