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Renal failure due to encrusted cystitis and pyelitis

Katsuhiro Ito1, Toshifumi Takahashi1, Toru Kanno1

  • 1Department of Urology Ijinkai Takeda General Hospital Kyoto Japan.

IJU Case Reports
|August 4, 2020
PubMed
Abstract

Insights

Encrusted cystitis and pyelitis, a rare infection causing urinary tract calcification, can progress to kidney damage if diagnosis is delayed. Prompt treatment with antibiotics and bladder irrigation can lead to regression.

Area of Science:

  • Urology
  • Infectious Diseases
  • Nephrology

Background:

  • Encrusted cystitis and pyelitis are uncommon urinary tract infections characterized by calcification within the urinary collecting system.
  • This case highlights the potential for rapid progression of encrusted cystitis to pyelitis and renal failure.

Observation:

  • A 73-year-old male with granulomatosis with polyangiitis presented with hematuria and dysuria.
  • Initial cystoscopy revealed bladder wall calcification, misdiagnosed as a bladder stone.
  • Over a month, calcification spread to the renal pelvis, causing bilateral renal failure.

Findings:

  • The patient received bilateral nephrostomy, bladder irrigation with Solita T1, and intravenous vancomycin.
  • Significant regression of calcification was observed after 4 weeks of treatment.
  • Alkaline urine and urothelial calcification are key indicators for suspecting encrusted cystitis and pyelitis.

Implications:

  • Early diagnosis and intervention are crucial to prevent severe renal complications.
  • Treatment strategies should encompass antibiotics, urine drainage, and chemolysis via bladder irrigation.
  • This case underscores the importance of considering rare infections in patients with atypical urinary symptoms.
Keywords:
Corynebacterium urealyticumencrusted cystitisencrusted pyelitisinfectionrenal failure

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