Peribacillus simplex and Klebsiella pneumoniae responsible for pyonephrosis with secondary psoas abscess: a case...

Area of Science:

• Urology
• Infectious Diseases
• Microbiology

Background:

• Bacterial urinary tract infections (UTIs) range from simple cystitis to severe pyelonephritis.
• Pyonephrosis, pus in the renal collecting system, necessitates urgent urological intervention to prevent sepsis.
• Complicated UTIs can lead to severe outcomes, including renal abscesses and systemic infection.

Observation:

• A 64-year-old diabetic female presented with acute right lumbar pain, fever, and altered consciousness.
• Imaging revealed severe right hydronephrosis, pyonephrosis, and a perirenal phlegmon with psoas abscess formation.
• The patient underwent surgical drainage and nephrectomy for the severe infection.

Findings:

• Microbiological and proteomic analyses identified Klebsiella pneumoniae and Peribacillus simplex as causative agents.
• This is the first reported case of pyonephrosis attributed to Peribacillus simplex.
• The identified bacteria formed a complex infection involving the kidney and the psoas muscle.

Implications:

• Highlights Peribacillus simplex as a potential pathogen in severe human infections, often overlooked.
• Underscores the importance of stringent protocols to prevent environmental bacteria contamination in clinical settings.
• Successful pyonephrosis management requires timely surgical drainage and targeted antibiotic therapy guided by culture and sensitivity testing.