Cases reported "urinary tract infections"

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1/750. Unaccountable severe hypercalcemia in a patient treated for hypoparathyroidism with dihydrotachysterol.

    This report describes a forty-seven-year-old female patient with a complex medical history. She was suffering from an unspecified interstitial lung disease, papillary thyroid carcinoma which had been treated, hypoparathyroidism after thyroidectomy for which she was receiving dihydrotachysterol and calcium, and atrial fibrillation and congestive heart failure as a result of mitral stenosis. Shortly after mitral valve replacement she developed a severe hypercalcemia (serum calcium 5.95 mmol/l) during a febrile illness. At that time anti-tuberculous agents were also being administered for presumed tuberculosis. The possible mechanisms for this severe elevation of the calcium level are discussed. immobilization, while Paget's bone disease was present, and perhaps enhanced activation of dihydrotachysterol by rifampicin, could have led to increased calcium-release into the circulation. Continuous supplecation of calcium and vitamin d, provoked dehydration and the mechanism of the milk-alkali syndrome also contributed to this extremely high calcium level. It is concluded that hypoparathyroid patients being treated with vitamin d and calcium should be carefully monitored in the case of an intercurrent illness or a change in medication. ( info)

2/750. The Ask-Upmark kidney: a form of ascending pyelonephritis?

    The case is presented of a young girl with recurrent urinary tract infection and vesico-ureteric reflux who developed a small scarred kidney and subsequently, hypertension. Pathologically, the renal changes were compatible with those of an Ask-Upmark kidney. The pathogenesis of the Ask-Upmark kidney is discussed. It is postulated that the lesion is not necessarily of congenital origin but may well be related to infection and intrarenal reflux, it is concluded that long-term follow-up of a young patient with a scarred kidney is indicated. ( info)

3/750. New aspects of urinary tuberculosis.

    In urinary tuberculosis, during recent years, there has been remarkable progress in treatment but some new aspects are reported, which raise problems in diagnosis and therapeutics. There is an increase of silent forms, forms with rapid destructive development, even under treatment, and forms masked by association with other diseases. The percentage of elderly patients has increased, as has the number of cases presenting with advanced lesions with little clinical manifestation. This calls for more careful searching, assessment and survey of any suspected case. ( info)

4/750. nitrofurantoin-associated Sweet's syndrome.

    A 53-year-old woman was seen for arthralgias, fever, and a painful rash developing at the end of a 7-day course of nitrofurantoin for a urinary tract infection. Her only other medication was naproxen, which was started after the onset of symptoms. Initial biopsy showed microscopic changes suggestive of a toxic eruption, but within 3 days the clinical signs and symptoms typical of Sweet's syndrome evolved. A repeat biopsy showed microscopic features characteristic of that diagnosis. The patient subsequently cleared with prednisone therapy. We report this patient as a case consistent with drug-induced Sweet's syndrome induced by nitrofurantoin. ( info)

5/750. Enterovesical fistula complicating pregnancy. A case report.

    BACKGROUND: Enterovesical fistula is a rare cause of recurrent urinary tract infections. This condition is unusual in young people as common etiologies include diverticular disease and cancer. When an enterovesical fistula occurs in women of childbearing age, Crohn's disease is a likely cause. To our knowledge, enterovesical fistula complicating pregnancy has not been reported before. CASE: A pregnant woman with recurrent urinary tract infections was evaluated. cystoscopy was suggestive of an enterovesical fistula, which was confirmed by charcoaluria following oral charcoal administration. The prenatal course was complicated by two episodes of hemorrhagic cystitis despite antibiotic prophylaxis. The patient had an uncomplicated term spontaneous vaginal delivery. An upper gastrointestinal series performed postpartum was suggestive of Crohn's disease and confirmed an enterovesical fistula. Surgical repair was successfully performed three months following delivery, revealing Crohn's disease. CONCLUSION: Enterovesical fistula may be an unusual cause of recurrent urinary tract infections in pregnancy. In this case, enterovesical fistula was the presenting symptom of Crohn's disease. ( info)

6/750. Congenital bladder diverticula in children.

    BACKGROUND/PURPOSE: The authors report their experience with the management of congenital bladder diverticula in children. methods: The authors reviewed the histories of six boys (mean age, 4.4 years) in whom congenital bladder diverticula was treated from 1980 to 1996. Diverticula were unilateral in four patients and bilateral in two patients. All patients presented recurrent urinary tract infection, and two boys had several episodes of urinary retention. Secondary kidney damage was present in two patients with ureteral obstruction and one with vesicoureteral reflux. Surgical treatment was undertaken in all patients. RESULTS: After surgical treatment, none of the patients has had recurrence of the diverticula, and all remain asymptomatic. CONCLUSIONS: Congenital bladder diverticula have a wide clinical spectrum and could lead to severe kidney damage. Urinary tract infection and urinary retention are the most frequent presentation forms. Surgical treatment should be indicated in all symptomatic cases according to each anatomic and functional situation. ( info)

7/750. Laser ablation of urethral hair.

    BACKGROUND AND OBJECTIVE: Two separate cases involving laser ablation of hair follicles in the neourethra are described. STUDY DESIGN/MATERIALS AND methods: Urethral hair developed secondarily to free-flap urethroplasty for congenital urethral defects. In both cases, cystoscopic depilation with electrocautery fulguration was attempted on multiple occasions. RESULTS: No improvement was seen; therefore, laser ablation was employed. Both patients remain free of regrowth at greater than one year of follow-up. ( info)

8/750. autonomic dysreflexia presenting as a severe headache.

    hypertension, bradycardia, and severe headache have been associated with autonomic dysreflexia. autonomic dysreflexia affects those with spinal transection above the level of T6 after plastic changes of the afferent pathways. This restructuring in the presence of noxious stimuli below the level of the lesion leads to autonomic dysreflexia. The onset of the first episode of autonomic dysreflexia has been documented as soon as 30 days and as late as 13 years after the injury. This report presents a case study of a paraplegic man 8 years after injury with autonomic dysreflexia associated with a urinary tract infection. ( info)

9/750. Emphysematous pyelonephritis: case report and review of the literature.

    Emphysematous pyelonephritis (EP), a rare necrotizing infection of the upper urinary tract, is a life-threatening complication of patients with diabetes mellitus. A case of EP is described where the diagnosis was delayed for 36 h and the patient died notwithstanding aggressive medical and surgical intervention. The demonstration of gas in the renal structures is pathognomonic of EP. Because early diagnosis and aggressive medical and surgical management is imperative for recovery, we recommend plain abdominal radiographs as a minimal screening tool for all diabetic patients who present to hospital with a presumptive pyelonephritis. The diagnosis should also be considered in patients who failed appropriate medical therapy. ( info)

10/750. Clean technique for intermittent self-catheterization.

    Seven patients with neurogenic bladder dysfunction who ranged in age from 16 to 54 years, and who had been on sterile intermittent self-catheterization, were changed to clean intermittent self-catheterization. urine was monitored for one year after changing to clean technique. urine specimens obtained while on clean technique were bacteriologically equivalent to urine specimens examined while patients were on sterile technique; the only exception to equivalent urine results were in patients who did not catheterize themselves at frequent intervals. Renal function tests on all patients were also normal. The clean, intermittent self-catheterization technique was effective, since infection did not seem to be caused by introducing bacteria into the bladder via the urethra. ( info)
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