Acute pyelonephritis caused by Mycoplasma hominis

Area of Science:

• Nephrology
• Infectious Diseases
• Urology

Background:

• Mycoplasma hominis is an opportunistic pathogen that can cause genitourinary infections.
• Nephrocalcinosis and upper urinary tract stones are predisposing factors for urinary tract infections.

Observation:

• An elderly male with a history of alcoholism, nephrocalcinosis, and upper urinary tract stones presented with fever, acute abdominal signs, and ascites.
• Laparotomy revealed significant ascites and confirmed acute pyelonephritis.
• Intraoperative renal pelvis urine culture identified Mycoplasma hominis.

Findings:

• Initial antibiotic treatment with cefuroxime was ineffective.
• Subsequent treatment with doxycycline led to definite clinical improvement.
• This case represents an unusual presentation of pyelonephritis with peritoneal involvement due to Mycoplasma hominis.

Implications:

• Mycoplasma hominis should be considered in the differential diagnosis of complicated urinary tract infections, especially in immunocompromised or debilitated patients.
• The presence of ascites and peritoneal signs in pyelonephritis may indicate an unusual pathogen or complicated infection.
• This case underscores the importance of appropriate microbiological diagnosis and targeted antibiotic therapy for Mycoplasma hominis infections.