struvite and Corynebacterium-Infections

Encrusted cystitis is a very rare chronic inflammatory disease of the bladder characterized by precipitation and incrustation of phosphate and ammonium-magnesium salts on the vescical mucosa, caused by urinary infection due to urolithic microorganisms. Corynebacterium urealyticum or Corynebacterium group D2, a multiple antibiotic-resistant urea-splitting bacterium, is the most frequently incriminated aetiology. We report a case of a 57-year-old man affected by systemic erythematosus lupus with a long history of dysuria and suprapubic pain who underwent percutaneous nephrostomy drainage with urethral stenting for lupoid obstructive uropathy. Before the diagnosis of encrusted cystitis by Corynebacterium urealyticum was established, the patient underwent five cystoscopies to remove the plaques and multiple unsuccessful antibiotic treatment courses. Eventually the infection was definitively cured after a two-week course with intramuscular teicoplanin.

Topics: Anti-Bacterial Agents; Apatites; Bacterial Proteins; Chemical Precipitation; Chronic Disease; Combined Modality Therapy; Corynebacterium; Corynebacterium Infections; Crystallization; Cystitis; Drug Resistance, Multiple, Bacterial; Humans; Hydronephrosis; Immunocompromised Host; Lupus Erythematosus, Systemic; Magnesium Compounds; Male; Nephrostomy, Percutaneous; Phosphates; Pyelitis; Remission Induction; Stents; Struvite; Teicoplanin; Urease

To report our experience with the management of encrusted cystitis and pyelitis (EC and EP) in the pediatric population. EC and EP are well-known entities in adults but are rarely identified in children. They consist of mucosal encrustations and are due to specific microorganisms.. Between 1996 and 2001, 4 children with a mean age of 9 years (range 4 to 13) were treated for EC (n = 2), EP (n = 1), and EC and EP (n = 1). The latter was a kidney transplant recipient. We retrospectively evaluated the clinical characteristics of the patients and the results of conservative management.. The delay between the beginning of the symptoms and the diagnosis was longer than 1 month in all cases. The diagnosis of EC was not evoked and was made during cystoscopy in all cases. EP was diagnosed during pyelotomy in 1 patient because it was evoked and confirmed by computed tomography scan in the kidney transplant recipient. Corynebacterium urealyticum was identified in the urine of all patients. EC was treated by antibiotics and endoscopic debulking, and EP was treated by antibiotics and local acidification. The duration of antibiotic therapy was between 1 and 6 months. The tolerance to local acidification of the kidneys was poor. Cure was achieved in 3 cases, but the treatment of EP failed in the kidney transplant recipient and graft removal was decided after 6 months of failed management because intractable febrile urinary tract infections became life threatening for the patient.. EC and EP are uncommon in children; however, these diseases must be considered. They must be diagnosed rapidly and require, if possible, conservative management. Nevertheless, kidney loss can occur in transplant recipients with EP.

Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Combined Modality Therapy; Corynebacterium; Corynebacterium Infections; Cystitis; Disease Susceptibility; Drug Therapy, Combination; Endoscopy; Female; Follow-Up Studies; Glycopeptides; Humans; Hydrogen-Ion Concentration; Isotonic Solutions; Kidney Transplantation; Magnesium Compounds; Male; Phosphates; Postoperative Complications; Pyelitis; Retrospective Studies; Struvite; Tomography, X-Ray Computed; Treatment Outcome; Urea; Urine

Topics: Aged, 80 and over; Bacterial Proteins; Carcinoma, Transitional Cell; Catheter-Related Infections; Corynebacterium; Corynebacterium Infections; Crystallization; Cystitis; Disease Susceptibility; Female; Humans; Hydronephrosis; Male; Postoperative Complications; Prostatectomy; Prostatic Neoplasms; Struvite; Urease; Urinary Bladder Neoplasms; Urinary Catheterization; Urinary Retention

Topics: Aged; Anti-Bacterial Agents; Biofilms; Catheter-Related Infections; Corynebacterium; Corynebacterium Infections; Humans; Male; Opportunistic Infections; Recurrence; Struvite; Urinary Catheterization; Urinary Tract Infections; Urolithiasis

Topics: Adult; Bacteremia; Corynebacterium; Corynebacterium Infections; Follow-Up Studies; Humans; Kidney Calculi; Magnesium Compounds; Male; Phosphates; Recurrence; Struvite

Topics: Corynebacterium Infections; Humans; Kidney Calculi; Magnesium; Magnesium Compounds; Phosphates; Struvite; Urinary Tract Infections

Struvite stones are caused by urea-splitting, usually gram-negative, organisms. A case of aggressive struvite stone production caused by Corynebacterium group F1 is reported that responded to the appropriate antibiotic treatment. To our knowledge this organism has never been associated previously with struvite stone formation.

Topics: Adult; Corynebacterium Infections; Humans; Kidney Calculi; Magnesium; Magnesium Compounds; Male; Phosphates; Struvite; Urinary Tract Infections

Corynebacterium D2, a saprophytic microorganism of skin, causes alkaline encrusted cystitis in patients with a previous bladder injury. In 5 patients that had presented this nosological entity, these gram-positive rods were isolated in urine cultures and calculi. Four patients had undergone urological instrumentation maneuvers and one patient (female) had a history of recurrent cystitis from gram-negative bacteria. Corynebacterium D2 grows slowly and under certain conditions, as those described above, must be considered pathological despite counts of less than 100,000/ufc-cc. It is ureolytic and highly resistant to antibiotics. The synergistic effects of antimicrobials, acetohydroxamic acid and transurethral resection of the lithiasic plaques achieve satisfactory treatment of alkaline encrusted cystitis from Corynebacterium D2.

Topics: Aged; Aged, 80 and over; Bacteriological Techniques; Corynebacterium; Corynebacterium Infections; Cystitis; Female; Humans; Magnesium; Magnesium Compounds; Male; Middle Aged; Phosphates; Struvite; Urea; Urinary Calculi; Urinary Catheterization

Corynebacterium group D2 inoculated into normal human urine formed struvite crystals and an increase in pH and ammonium concentration after 24 h of incubation. Zinc disks dipped into a broth culture of this microorganism and inserted into the bladders of rats produced stones with a mean weight of 12.5 mg (ranging from 1 to 57.7 mg) after 12 days. Analysis of the infrared spectrum determined the stones to be composed of struvite. From these results its seems that stone formation by Corynebacterium group D2 may be possible both in vitro and in vivo, which may confirm a previous report involving these bacteria in human clinical encrusted cystitis.

Topics: Animals; Corynebacterium; Corynebacterium Infections; Cystitis; Escherichia coli; Escherichia coli Infections; Female; Humans; Hydrogen-Ion Concentration; Magnesium; Magnesium Compounds; Phosphates; Proteus Infections; Proteus vulgaris; Rats; Rats, Inbred Strains; Struvite; Urinary Bladder Calculi