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Infected urachal remnants in the adult: case report and review
T T Ward1, E Saltzman, S Chiang
1Infectious Disease Section, Veterans Affairs Medical Center, Portland, Oregon.
Abstract:
Abnormalities of the urachus in adults are uncommon. Urachal tract remnants that abnormally remain patent are subject to infection. Urachal infection is frequently confused with a wide spectrum of midline intraabdominal or pelvic inflammatory disorders. Because the literature on urachal infection is primarily limited to articles in urology and surgical specialty journals, many physicians may not be familiar with the varied clinical manifestations. We describe a case of infection of a patent urachus in an adult and review the embryology and anatomy of the urachus as it relates to clinical presentation, evaluation, and management. Infection of a urachal remnant should be included in the broad differential diagnosis of omphalitis and midline abdominal or pelvic infections. Rarely, it may be a cause of recurrent urinary tract infection. Definitive management consists of surgical excision after the institution of antimicrobial therapy.
Insights
Urachal tract remnants can become infected in adults, mimicking other abdominal infections. Surgical excision after antibiotic treatment is the definitive management for this uncommon condition.
Area of Science:
- Urology
- Surgical Pathology
Background:
- Abnormalities of the urachus are rare in adults.
- Patent urachal tract remnants are susceptible to infection.
- Urachal infections often present with varied clinical manifestations, leading to misdiagnosis.
Observation:
- A case of infected patent urachus in an adult is presented.
- The embryology and anatomy of the urachus are reviewed in relation to clinical presentation.
- This condition can be mistaken for midline intraabdominal or pelvic inflammatory disorders.
Findings:
- Infection of a urachal remnant should be considered in the differential diagnosis of omphalitis and midline abdominal/pelvic infections.
- Rarely, urachal remnant infections can cause recurrent urinary tract infections.
Implications:
- Increased physician awareness of urachal infection presentations is crucial for accurate diagnosis.
- Definitive management involves surgical excision of the urachal remnant.
- Prompt diagnosis and treatment can prevent complications associated with misdiagnosed abdominal infections.