Related Experiment Video
Updated: Jun 20, 2026
06:09
Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
Published on: July 18, 2017
Penicillin G-induced hemorrhagic cystitis with hydronephrosis
Yuichiro Toma1, Tetsuya Ishiki, Kazufumi Nagahama
1The Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan. asikaga@yahoo.co.jp
Internal Medicine (Tokyo, Japan)
|September 17, 2009
Summary
Penicillin G can cause severe urinary tract issues, including hemorrhagic cystitis and acute kidney injury. Discontinuation of the antibiotic led to symptom resolution and kidney function recovery.
Area of Science:
- Nephrology
- Urology
- Pharmacology
Background:
- Endocarditis treatment often involves antibiotics like penicillin G.
- Drug-induced kidney injury is a significant clinical concern.
Observation:
- A patient developed gross hematuria, lumbar pain, and renal insufficiency during penicillin G therapy.
- Imaging revealed bladder wall thickening, hydroureter, and hydronephrosis, indicative of hemorrhagic cystitis with urinary tract obstruction.
Findings:
- Urine culture was negative, ruling out infection.
- Symptoms resolved, and renal function normalized after discontinuing penicillin G.
- Drug lymphocyte stimulation test (DLST) confirmed penicillin G hypersensitivity.
Implications:
- Penicillin G can be an iatrogenic cause of hemorrhagic cystitis and acute kidney injury.
- Careful monitoring for urinary symptoms is crucial during penicillin G treatment.
- DLST can aid in diagnosing drug-induced urological and renal complications.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
01:27Acute Pyelonephritis I: Introduction
Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
01:01Hypersensitivity Reactions: Cytolytic Reactions
Type II hypersensitivity involves IgG and IgM antibodies targeting cell surface antigens, leading to cell destruction. This can occur through complement activation, antibody-dependent cell-mediated cytotoxicity (ADCC), or acting as opsonins for phagocytosis. When excessive, these reactions cause significant tissue damage.Drug-induced hemolytic anemia is a common example, where drugs like penicillin or cephalosporins bind to red blood cells, forming drug-protein complexes. These complexes...
01:25Urinary Tract Infection II: Pathophysiology
The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
01:29Acute Kidney Injury II: Pathophysiology
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...