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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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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...
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Acute Pyelonephritis I: Introduction01:27

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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...
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Urinary Tract Infection II: Pathophysiology01:25

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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...
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The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
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Men's health issues are increasingly recognized as significant, with several conditions posing common threats. Among these, testicular cancer is especially prevalent in younger men, particularly those aged 20 to 35 years. The disease often manifests as a painless mass in the testicles, sometimes accompanied by a sensation of heaviness or a dull ache.
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Multi-organ pyoderma gangrenosum presenting as refractory prostatitis.

Ayushya Ajmani1, Kristan Schiele2, Dylan J Badin2

  • 1Student, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA.

BMJ Case Reports
|December 30, 2025
PubMed
Summary
This summary is machine-generated.

This case study details a rare instance of simultaneous pyoderma gangrenosum (PG) affecting both the skin and prostate. It emphasizes considering non-infectious causes for severe prostatitis with systemic inflammation.

Keywords:
DermatologyProstateProstatitisUrological surgery

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Area of Science:

  • Urology
  • Dermatology
  • Pathology

Background:

  • Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis.
  • Concurrent visceral and cutaneous PG is exceptionally uncommon.
  • Prostatic involvement in PG is not well-documented.

Purpose of the Study:

  • To report a rare case of concurrent cutaneous and prostatic pyoderma gangrenosum.
  • To highlight the diagnostic challenges and management of this rare condition.
  • To underscore the importance of considering non-infectious inflammatory conditions in refractory prostatitis.

Main Methods:

  • Case report of a male patient in his 70s.
  • Clinical presentation, diagnostic imaging (prostatic abscess), and histopathology (sterile neutrophilic inflammation) were analyzed.
  • Treatment involved transurethral resection, antibiotics, systemic corticosteroids, mycophenolate mofetil, and infliximab.

Main Results:

  • The patient presented with symptoms of bacterial prostatitis and a prostatic abscess.
  • Post-surgical intervention, he developed necrotic ulcers characteristic of cutaneous PG.
  • Histopathology confirmed sterile neutrophilic inflammation in both prostate and skin, consistent with PG.
  • Multidrug therapy led to partial disease control.

Conclusions:

  • This case represents a unique presentation of simultaneous visceral (prostatic) and cutaneous PG.
  • The findings emphasize the need to consider pyoderma gangrenosum in patients with refractory prostatitis and systemic inflammation, even without preceding trauma or surgery.
  • Early recognition and appropriate immunosuppressive therapy are crucial for managing this rare condition.