Bilateral chronic ureteritis associated with Serratia marcescens.

Area of Science:

• Urology
• Nephrology
• Infectious Diseases

Background:

• Bilateral obstructive uropathy is a serious condition requiring accurate diagnosis.
• Nonspecific chronic ureteritis can present diagnostic challenges, mimicking other conditions like tuberculosis or retroperitoneal fibrosis.
• Previous reports have focused on unilateral involvement, leaving bilateral cases less understood.

Observation:

• This case presents bilateral obstructive uropathy attributed to nonspecific chronic ureteritis.
• Pre-operative assessments suggested tuberculous infection or retroperitoneal fibrosis as potential causes.
• Diagnostic difficulties were encountered, consistent with prior observations of unilateral cases.

Findings:

• The infective organism identified was Serratia marcescens.
• The source of the Serratia marcescens infection was traced to the right kidney.
• This is the first reported instance of bilateral obstructive uropathy caused by nonspecific chronic ureteritis.

Implications:

• Highlights the importance of considering nonspecific chronic ureteritis in the differential diagnosis of bilateral obstructive uropathy.
• Emphasizes the diagnostic challenges associated with this condition, even with advanced imaging.
• Suggests Serratia marcescens as a potential pathogen in complex urinary tract infections leading to obstructive uropathy.