A case of emphysematous cystitis complicated by unilateral hydronephrosis and septicemia: nephrology picture.
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ABSTRACT:
SUBMITTER: Wathanavasin W
PROVIDER: S-EPMC9469812 | biostudies-literature | 2023 Mar
REPOSITORIES: biostudies-literature
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A case of emphysematous cystitis complicated by unilateral hydronephrosis and septicemia: nephrology picture.
Wathanavasin Wannasit W Susantitaphong Paweena P
Journal of nephrology 20220913 2
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Project description:IntroductionEmphysematous pyelonephritis (EPN) or cystitis (EC) is a severe infection of the urinary tract with high mortality. EPN is uncommon among the patients of end stage of renal failure (ESRD) CASE PRESENTATION:: A 38-year-old male with uremia and anuria who was on hemodialysis was found to have gas formation in the bilateral pelvis, ureters, and urinary bladder by CT scan. The diagnosis was emphysematous pyelonephritis and cystitis. And Foley catheter was placed and bladder irrigation was performed. Escherichia coli infection was identified in urine culture and antibiotic was prescribed accordingly. Gas disappeared completely and the patient recovered uneventfully.ConclusionThis is the first case report of asymptomatic EPN and EC in uremic patient, and conservative management was optimistic in this condition. More attention should be paid to EPN and EC happening to ESRD patients.
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Project description:An emphysematous cystitis s a rare urinary tract infectious disease and fatal unless any treatments. The case was a 97-year-old female presented with knee pain after falling with co-existence of macroscopic hematuria and pyuria. The ultrasonography examined on the same day showed a hyperechoic bladder-ring appearance bordering bladder wall which was re-was re-confirmed by computed tomography by air bubble collection on the circumferential bladder wall. We conclude and emphasize as the leaning point that emphysematous cystitis is raised as a differential diagnosis when ultrasonography showed the pathognomonic as hyperechoic bladder-ring appearance bordering bladder wall.
| S-EPMC8260742 | biostudies-literature
Project description:We report a rare but fatal case of emphysematous cystitis (EC) that presented as a typical image of gas bubbles within the urinary bladder wall on computed tomography (CT). This disease has a high mortality rate more than that reported previously based on recent literature review in Japan.
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Project description:BackgroundBoth disseminated intravascular coagulation and thrombotic microangiopathy are complications of sepsis as Salmonella septicemia, respectively. They are related and have similar clinical characteristics as thrombopenia and organ dysfunctions. They rarely co-occur in some specific cases, which requires a clear distinction.Case presentationA 22-year-old woman had just undergone intracranial surgery and suffered from Salmonella derby septicemia with multiorgan involvement in the hospital. Laboratory workup demonstrated coagulation disorder, hemolytic anemia, thrombocytopenia, and acute kidney injury, leading to the co-occurrence of disseminated intravascular coagulation and secondary thrombotic microangiopathy. She received antibiotics, plasma exchange therapy, dialysis, mechanical ventilation, fluids, and vasopressors and gained full recovery without complications.ConclusionDisseminated intravascular coagulation and secondary thrombotic microangiopathy can co-occur in Salmonella derby septicemia. They should be treated cautiously in diagnosis and differential diagnosis. Thrombotic microangiopathy should not be missed just because of the diagnosis of disseminated intravascular coagulation. Proper and timely identification of thrombotic microangiopathy with a diagnostic algorithm is essential for appropriate treatment and better outcomes.
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Project description:The aggregation of Latino subgroups in national studies creates an overly simplistic narrative that Latinos are at lower risk of mental illness and that foreign nativity seems protective against mental illness (i.e., immigrant paradox). This broad generalization does not hold up as the Latino population ages. Given that social inequalities for risk appear to widen with age, the social disadvantages of being Latino in the United States increase the risk for mental illness across the life span. This review focuses on the mental health of older Latinos, specifically the 3 subgroups with the longest residential history in the United States-Mexicans, Puerto Ricans, and Cubans. We examine relevant epidemiological and clinical psychopathology studies on aging in these Latino populations and present evidence of the heterogeneity of the older Latino population living in the United States, thus illustrating a limitation in this field-combining Latino subgroups despite their diversity because of small sample sizes. We address the migration experience-how intraethnic differences and age of migration affect mental health-and discuss social support and discrimination as key risk and protective factors. We conclude with a discussion on meeting the mental health needs of older Latinos with a focus on prevention, a promising approach to addressing mental illness in older Latinos, and future directions for mental health research in this population. Success in this endeavor would yield a substantial reduction in the burden of late-life depression and anxiety and a positive public health impact.
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Project description:IntroductionHerlyn-Werner-Wunderlich syndrome is a rare congenital disorder that consists of a didelphic uterus, hemivaginal septum, and unilateral renal agenesis. Both diagnosis and management can be challenging in low-income countries.Case presentationa 13-year-old female who experienced recurrent pelvic pain, dysmenorrhea, and abdominal mass for one month. We could not obtain the MRI as it was unavailable in our hospital, and the patient cannot afford its expensive cost in a private center. Instead, US showed an absent right kidney and doubled uterus with a heterogeneous cystic formation. A pelvic CT scan revealed an absent right kidney, an enlarged left kidney, a double uterus, and a left hematocolpos. We established the diagnosis of Herlyn-Werner-Wunderlich syndrome and started planning for correcting the anomalies via laparotomy.Discussionultrasound detects uterus didelphys, hematocolpos, hematometrocolpos, and renal agenesis but cannot identify the vaginal septum and the type of müllerian defect. The MRI is more convenient for a thorough assessment, but it is a high-priced diagnostic method.Conclusionalthough MRI is the gold standard for establishing the diagnosis and preoperative planning, ultrasound and CT scan can be an alternative, less expensive, and reliable approach. In addition, Laparoscopy or vaginoscopy may not be available in these countries. Therefore, correcting the anomalies can be achieved with laparotomy, which results in acceptable outcomes without any complications.
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| S-EPMC5958765 | biostudies-literature
Project description:IntroductionAcquired renal arteriovenous fistulas (AVFs) include those that occur as a complication of renal biopsy.Case reportThe authors report the case of a woman with recent-onset grade I hypertension, who was referred to our staff for sonographic studies of the kidneys and urinary tract. Laboratory data revealed microhematuria and proteinuria <0.5 g/24 h, and renal function was borderline (MDRD GFR 58 mL/min). Renal sonography of the left kidney revealed an anechoic, arboriform area at the level of the pelvis, which was suggestive of hydronephrosis. The color Doppler examination showed turbulent flow within the anechoic area, with high-velocity arterial flow and arterialization of the venous waveform at spectral analysis. Selective renal angiography later confirmed the presence of a middle renal AVF with pseudoaneurysm, which had been provoked by a renal biopsy performed over 10 years earlier in another center. Since the patient was currently in good health, the prescribed management consisted solely of close clinical and US follow-up.DiscussionAV fistulas are among the most commonly diagnosed renovascular malformations. The case reported here underlines the importance of using color Doppler ultrasound when obstructive uropathy is suspected, especially in patients who have undergone renal biopsy.
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| S-EPMC9628586 | biostudies-literature
Project description:IntroductionEmphysematous pyelonephritis is a rare necrotizing infection of the kidney. It should be diagnosed early because it has a bad prognosis. Treatments range from intravenous antibiotics to nephrectomy in severe cases.Presentation of caseA 67 years old female with uncontrolled diabetes mellitus presented with fever, right flank pain, and dysuria. Computed tomography for abdominal and pelvis showed gas inside the right kidney. After administration of intravenous antibiotics, she underwent right nephrectomy. Next, she was admitted to intensive care unit for monitoring. After three days, she was discharged with no complains. Follow-up for three months showed full recovery.Clinical discussionEmphysematous pyelonephritis is an emergent condition. A history of uncontrolled diabetes mellitus with current flank pain with fever raises the suspicion. Computed tomography could be performed to confirm the diagnosis.ConclusionSevere cases of emphysematous pyelonephritis are an emergent condition that needs nephrectomy.
| S-EPMC8818935 | biostudies-literature