Cases reported "Cystitis"

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1/26. Encouraging results in the treatment of haemorrhagic cystitis with estrogen - report of 10 cases and review of the literature.

    Haemorrhagic cystitis (HC) after allogeneic haematopoietic stem cell transplantation (HSCT) or high-dose cyclophosphamide (CP) chemotherapy is a severe side-effect and can cause significant morbidity and mortality. In this report, we describe the clinical courses of 10 patients with HC and review the literature. The patients were treated with oral conjugated estrogen in an attempt to improve severe haemorrhagic cystitis. In seven patients positive effects were seen, haematuria resolved in all, but residual symptoms of dysuria remained for longer periods. In one patient application of estrogen was interrupted because of hepatotoxicity. Two patients failed all treatment modalities including oral estrogen because of terminal illness. We conclude that in the management of HC the administration of oral conjugated estrogen should be considered.
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2/26. Eosinophilic cystitis in a case presenting with an initial diagnosis of invasive bladder tumor.

    Eosinophilic cystitis is a rare condition of the bladder that presents with hematuria, dysuria and suprapubic tenderness. A case of eosinophilic cystitis presenting as an invasive bladder tumor is reported.
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3/26. Tumoral cystitis in children.

    Three children aged 3-11 years had ultrasonography of the urinary tract for the investigation of dysuria and haematuria. A bladder mass was seen in these 3 children. One child had computed tomography scan, cystoscopy and bladder biopsy because rhabdomyosarcoma was considered. The biopsy revealed an inflammatory process. The urine culture of the other 2 children revealed E. coli. On ultrasonography, the inflammatory mass may appear homogeneously hypoechoic or may contain moderate level echoes. The mucosal surface of the mass may be smooth or lobulated. It is important to consider an infective cause for a bladder mass in children because computed tomography, cystoscopy and biopsy may be avoided.
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4/26. Emphysematous cystitis in a patient presenting with paradoxical arterial embolism and intestinal mycobacteriosis without evidence of diabetes.

    We describe the case of a 72-year-old woman who displayed massive multiple intramural gas collections of the bladder wall as an incidental finding on CT. The patient presented with critical ischemia of the left leg caused by paradoxical arterial embolism, raised corpuscular sedimentation rate, anemia by gastrointestinal blood loss, hypoproteinemia, diarrhea, malabsorption, and exudative enteropathia caused by mycobacterial ileocolitis. The patient had no dysuria and there was no evidence of diabetes. The intramural gas collections of the bladder wall, as shown by CT, were compatible with emphysematous cystitis. urine samples proved infection by a multi-resistant strain of E. coli. Emphysematous cystitis is a rare form of bladder infection that can be diagnosed by plain-film radiograms or CT.
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5/26. Eosinophilic cystitis in a 4-year-old boy: successful long-term treatment with cyclosporin A.

    A 4-year-old Jewish boy presented with dysuria, urinary dribbling, increased urinary frequency, and new onset of diurnal enuresis. An infiltrating solid mass involving the entire bladder wall was found. biopsy revealed "tumor-forming" eosinophilic cystitis, a rare bladder lesion of unclear cause. Antitoxocariasis treatment was unsuccessful. High-dose corticosteroids failed. The child's clinical condition and bladder sonographic findings continued to deteriorate. Treatment with cyclosporin A was given for 8 months, with a complete clinical, radiologic, and histopathologic cure and no side effects. Two years of follow-up showed a complete recovery.
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keywords = dysuria
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6/26. cystitis glanduralis complicating an eosinophilic cystitis: a case report.

    We report on a rare case of cystitis glandularis complicating an eosinophilic cystitis in an adult. Complaints at presentation included dysuria, haematuria and abdominal pain. Ultrasound and cystoscopy suggested a bladder tumor. Histological analysis of bladder biopsy showed the typical findings of cystitis glandularis associated with eosinophilic cystitis. The patient was treated with transurethral resection of the lesion and a combination of corticosteroids and anthistaminics for three months. He is disease-free at 24 months of follow-up.
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7/26. Eosinophilic cystitis in children.

    A case of eosinophilic cystitis in a child is presented and the pediatric literature reviewed. The etiology of this condition is still unknown. Mean age of children with eosinophilic cystitis is 5.9 years. Black children appear to be more affected than white children, with a male preponderance. hematuria and dysuria are the most common symptoms. The diagnosis of eosinophilic cystitis is made by cystoscopy with biopsy. The disease appears self-limited with its course unaltered by antibiotics. recurrence of eosinophilic cystitis is possible.
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8/26. Emphysematous cystitis: rapid resolution of symptoms with hyperbaric treatment: a case report.

    INTRODUCTION: Emphysematous cystitis is a rare disease that occurs most often in elderly diabetic patients characterized by gas formation in the bladder wall due to infection. The infecting organism is usually an aerobic bacterium, most commonly E. coli although anaerobic species have also been reported. We report the use of hyperbaric oxygen in a patient with emphysematous cystitis and air in the femoral vein in which the treatment rapidly resolved the symptoms and radiological abnormalities. methods: A 65-year-old female presented to the Emergency Department with altered mental status, weakness, dark urine, dysuria and fever. She was febrile and lethargic. Abdominal exam showed suprapubic tenderness. urinalysis was positive for white blood cells and bacteria. A CT scan of the abdomen demonstrated extensive air in the bladder wall with an air bubble in the femoral vein. Presumptive diagnosis was urinary tract infection, emphysematous cystitis, and sepsis. A question of air embolism was raised due to the intravascular gas. The patient was treated with hyperbaric oxygen (2.85 atm abs, 90 minutes) on two separate occasions in the first 12 hours. Within 24 hours, the patient's condition rapidly improved. Repeat CT scan 48 hours after admission showed near complete resolution of the emphysematous cystitis. The patient grew klebsiella pneumonia from her urine. CONCLUSIONS: Emphysematous cystitis is a rare condition caused by either aerobic or anaerobic bacteria and may be associated with both bladder wall and intravascular gas formation. Hyperbaric oxygen therapy has not been previously reported as a treatment modality. The rapid improvement in our patient may indicate a role for hyperbaric oxygen in addition to IV hydration and antibiotics in this disease.
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9/26. Hemorrhagic adenovirus cystitis after renal transplantation.

    PURPOSE: Viral infections are a major cause of postoperative morbidity and mortality after renal transplantation. Although cytomegalovirus, Epstein-Barr virus, and polyoma virus infections are common, there have been only a few reports of adenovirus infections. MATERIALS AND methods: We report an unusual case of a patient with adenovirus-induced hemorrhagic cystitis (AHC). We also performed a comprehensive medline review to identify similar cases. We then compared the presentation, management, and outcome of all patients to identify patterns that may facilitate the diagnosis and management of AHC. RESULTS: review of the literature revealed 36 other reported cases of AHC in renal transplant recipients. Thirty-six of the 37 cases occurred within 1 year of transplantation. These patients presented with fever, dysuria, hematuria, and graft dysfunction. Thirty-four received high-dose steroids for treatment of symptoms of acute rejection. Four patients received antiviral medications. The infection was self-limited with mean duration of symptoms being 20 days. In all cases, serum creatinine returned to baseline or near baseline levels with resolution of symptoms. CONCLUSIONS: Although uncommon, AHC usually presents within 1 year of renal transplantation with a consistent constellation of symptoms. The infection appears to be self-limited with full recovery in most patients within 4 weeks. The efficacy of antiviral medications could not be determined in this review.
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10/26. Clinical manifestations and functional outcomes in children with eosinophilic cystitis.

    PURPOSE: Eosinophilic cystitis is a rare disorder, with fewer than 30 pediatric cases reported in the literature. We describe our experience with pediatric eosinophilic cystitis during a 20-year period. MATERIALS AND methods: Four children referred to our institution were subsequently diagnosed with eosinophilic cystitis between 1984 and 2004. A retrospective chart review was performed to assess clinical presentation, diagnosis, treatment and outcomes. RESULTS: Mean patient age at presentation was 10.8 years (range 5 to 18) and male-to-female ratio was 3:1. All 4 patients presented with irritative urinary symptoms, including 3 with dysuria and/or gross hematuria and 2 with urinary frequency, lower abdominal pain and/or a concomitant urinary tract infection. Allergic diseases (asthma, allergic rhinitis, etc) were present in 3 patients, and a formal allergen skin test was positive in 2 of those tested. A bladder mass mimicking malignancy was documented in 2 patients. Three patients had symptom resolution with conservative treatment, while 1 had development of an unremitting tumefactive process that eventually required partial cystectomy and bladder augmentation. CONCLUSIONS: Eosinophilic cystitis is a rare condition with a wide range of clinical manifestations. Children can present with a bladder mass mimicking sarcoma, underscoring the need for biopsy before diagnosis and treatment of a presumed oncological process. The condition usually follows a benign course, although unremitting progression remains a possibility.
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