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Cystitis with ureteral reflux caused by ureaplasma urealyticum
Urology
|February 1, 1985
Summary
Ureaplasma urealyticum can cause urinary symptoms like pyuria and hematuria, even with negative standard cultures. Treating this infection with doxycycline resolved symptoms and improved ureteral reflux in a teenage boy.
Area of Science:
- Pediatric Urology
- Infectious Diseases
- Microbiology
Background:
- Urinary tract infections (UTIs) in adolescents can present with complex symptoms.
- Negative routine urine cultures often pose diagnostic challenges.
- Ureaplasma urealyticum is a potential pathogen in genitourinary infections.
Observation:
- A 15-year-old male presented with urgency, suprapubic pain, hematuria, and pyuria.
- Initial urine cultures were negative, but cystoscopy showed cystitis and VCUG revealed bilateral reflux and ureteral dilatation.
- Further investigations included renal arteriograms, percutaneous renal biopsy, and bladder biopsy.
Findings:
- A positive culture for Ureaplasma urealyticum was identified.
- Treatment with doxycycline led to symptom resolution.
- Follow-up VCUG demonstrated improvement in the ureteral reflux.
Implications:
- Ureaplasma urealyticum should be considered in cases of symptomatic pyuria with negative routine cultures.
- Ureteral reflux may be a reversible manifestation of Ureaplasma infection.
- This case highlights the importance of considering atypical pathogens in pediatric UTIs.