scholarly journals mNGS helped diagnose scrub typhus presenting as a urinary tract infection with high D-dimer levels: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mei-fang Liu ◽  
Yong Liu ◽  
De-rong Xu ◽  
La-gen Wan ◽  
Rui Zhao
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Scrub Typhus ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Kidney Injury ◽  
History Of ◽  
D Dimer

Abstract Background Scrub typhus is caused by O. tsutsugamushi and spreads through mite larvae biting the skin. Classic symptoms of the disease are eschar and lymphadenopathy. Previous reports have revealed clinical manifestations of scrub typhus, including gastrointestinal symptoms, meningoencephalitis, ocular flutter, pneumonitis, acute respiratory distress syndrome, and acute kidney injury. However, cases of scrub typhus presenting as a urinary tract infection (UTI) with high D-dimer levels could be easily misdiagnosed when clinical attention is insufficient, resulting in difficulty in making a timely diagnosis of the infection. Metagenomics next-generation sequencing (mNGS) is a revolutionary and highly sensitive method that may help in diagnosing atypical cases, even when trace amounts of pathogens are present. Case presentation A 52-year-old female presented with a 10-day history of fever, chills, headache and myalgia. She was initially diagnosed with influenza at a local clinic. Various antibacterials were used on the 2nd–12th day onwards; however, her symptoms persisted and were followed by increased urination duration, frequency, urgency and dysuria for 2 days. Orientia tsutsugamushi was confirmed as the pathogen responsible for the infection through mNGS analysis of her blood samples from Day 13 onwards. The patient’s temperature changed remarkably 24 h after the initiation of doxycycline. Over the next 48 h (i.e., Day 15 onwards), the patient showed clinical improvement. She recovered and was discharged from the hospital. Conclusions Scrub typhus can present atypical clinical symptoms, such as UTIs, in a febrile patient. mNGS may be a useful method for identifying O. tsutsugamushi infection in patients with atypical clinical manifestations.

scholarly journals P1793MICROBIAL URETERAL STENT COLONIZATION IN KIDNEY TRANSPLANTATION: INCIDENCE AND IMPACT IN URINARY TRACT INFECTION AND RENAL FUNCTION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Melissa Rau ◽  
Anna Carrera Salinas ◽  
Sara Marti ◽  
Maria Fiol ◽  
Begoña Etcheverry ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Kidney Transplantation ◽  
Urinary Tract ◽  
Tract Infection ◽  
Clinical Symptoms ◽  
Previous History ◽  
Ureteral Stent ◽  
Stent Insertion ◽  
History Of ◽  
Tract Infections

Abstract Background and Aims Ureteral stent insertion is nowadays a common practice in kidney transplantation, leading to a dramatic reduction of surgical issues. On the other hands, urinary tract infections are the most common complication in the first months after transplant. Main scope of our study was to analyze the incidence of stent colonization and its impact on the development of urinary tract infection (UTI) in the first six months after transplantation Method Prospective observational study including 23 consecutively recruited patients at one single center. Patients with a previous history of surgical intervention on urinary tract before transplant were excluded. Pigtail stents were removed as for local protocol between 3 and 4 weeks after transplantation in aseptic condition and were cut in a half (proximal and distal) and analyzed separately. Stent colonization were detected by sonication method. Urine culture timing are depicted in Figure 1. In case of clinical symptoms, extra urine cultive were performed as for clinical practice. Patient were followed for 6 months, and results of stent colonization were blinded to clinicians. Results Table 1 shows main characteristic of our cohort. Conclusion

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

scholarly journals Escherichia coli bacteremia due to urinary tract infection complicated by acute myocarditis: A rare complication

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110236
Author(s):  
Mohamadanas Oudih ◽  
Thana Harhara
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acute Myocarditis ◽  
Rare Complication ◽  
Kidney Injury ◽  
St Segment Elevation ◽  
Infection Treatment ◽  
St Segment

Acute myocarditis is a rare complication of Escherichia coli urinary tract infection and sepsis. We report the case of a previously healthy 55-year-old female who presented to our emergency department with diarrhea and hypotension. The basic metabolic panel results showed an increase in inflammatory markers and an acute kidney injury. Urine and blood cultures grew Escherichia coli. The patient subsequently developed sudden chest pain and shortness of breath, diffuse ST-segment elevation, and cardiac enzymes’ elevation. Coronary angiogram was normal, and transthoracic echocardiogram demonstrated normal ventricular functions. Cardiac magnetic resonance imaging was highly suspicious of myopericarditis. The patient made a full recovery after infection treatment with intravenous antibiotics, aspirin, and colchicine.

scholarly journals URINARY BLADDER GOSSIPYBOMA

2006 ◽  
Vol 13 (01) ◽  
pp. 160-161
Author(s):  
MUHAMMAD IJAZ ◽  
BASHIR UR REHMAN ◽  
REHAN-E- KIBRIA
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Urinary Bladder ◽  
Tract Infection ◽  
Recurrent Uti ◽  
History Of

A 57 years old gentleman was brought with history of recurrent UTI (Urinary tract infection) of 01 yearduration. Following transvesical prostatectomy. UTI could not be controlled after using appropriate antibiotics. Allrelevant investigations were performed. His cystoscopic examination revealed retained gauze piece (12 inches ) inurinary bladder, which was retrieved.

scholarly journals Acute kidney injury in kidney rupture and urinary tract infection in A 6-year-old-boy

2017 ◽  
Vol 48 (2) ◽  
pp. 142
Author(s):  
Dinna Auliawati ◽  
Gusti Ayu Putu Nilawati ◽  
I Ketut Suarta ◽  
Wayan Yudiana
Keyword(s):  
Acute Kidney Injury ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Kidney Injury ◽  
Kidney Rupture

scholarly journals CAPSULE PRODUCTION PATTERN OF UROPATHOGENIC ESCHERICHIA COLI OF URINARY TRACT INFECTION PATIENTS IN KIRKUK HOSPITALS

2020 ◽  
Vol 17 (35) ◽  
pp. 621-627
Author(s):  
May Ali Hussien UMRAN ◽  
Sumaya Najim AL-KHATEEB
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Clinical Manifestations ◽  
Uropathogenic Escherichia Coli ◽  
E Coli ◽  
Intestinal Pathogens ◽  
Production Pattern ◽  
Living Organisms

The bacterium Escherichia coli is one of the best free-living organisms studied in depth. It is a surprisingly diverse species, since some strains of E. coli live in the intestine of animals as harmless commensals, while other distinct genotypes, such as an enteropathogenic or enterohemorrhagic E. coli, for example, cause morbidity and death marked as human intestinal pathogens. The purpose of this study was to develop and validate a PCR assay for a known and suspected uropathogenic E. coli virulence factor (kpsMT) gene region to determine the distribution of the gene and its role in the development of clinical diseases of the urinary system. A total of 25 urine samples were collected from patients with urinary tract infection (UTI) at Azadi and Kirkuk hospitals in the city of Kirkuk, Iraq. Samples of both genders and different ages were collected from patients with suspected urinary tract infection according to the clinical manifestations and symptoms diagnosed by the examining physician. The samples were cultured and positive samples were subjected to the IMViC test to identify E. coli bacteria and subsequently identified using the Vitek 2 compact system. Among 25 samples, 24 (96%) showed positive results for bacterial cultural growth. Of these, 17 (68%) were identified as Escherichia coli. Of the total of 17 isolates, 14 from patients with mild urinary tract infection, and 3 from patients with Urosepsis. The kpsMT gene was present in 14 isolates (82.3%), including 11 (78.5%) isolates from patients with mild urinary tract infection, and 3 (100%) isolates from patients with Urosepsis. It was concluded that Escherichia coli is the most prevalent in urine tract infection samples. Due to the abundance of the kpsMT gene in uropathogenic Escherichia coli (UPEC), this gene plays an important role in developing UTI if it is not treated correctly and quickly; mild cases of UTI can turn into Urosepsis.

scholarly journals Risk factors of multidrug-resistant bacteria in community-acquired urinary tract infections

2021 ◽  
Vol 21 (1) ◽  
pp. 214-9
Author(s):  
Ertugrul Guclu ◽  
Fikret Halis ◽  
Elif Kose ◽  
Aziz Ogutlu ◽  
Oğuz Karabay
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Multidrug Resistant ◽  
Antibiotic Usage ◽  
Advanced Age ◽  
History Of ◽  
Tract Infections

Background: Urinary tract infections (UTIs) are one of the most seen infection among community. Objectives: In this cross-sectional study we aimed to investigate the risk factors of multidrug-resistant (MDR) bacteria that caused community-acquired UTI (CA-UTI). Methods: Consecutive patients admitted to the Urology and Infectious Diseases policlinics with the diagnosis of CA-UTI were included in the study. A standard form including possible predisposing factors for MDR bacteria was applied. Results: In total, 240 patients (51.3% females) were enrolled in the study. The mean age of participants were 59.8 ± 18.3 years old. Escherichia coli (n =166; 69.2%)was the most frequently isolated bacteria and its incidence was higher in females than in males (p=0.01). In total, 129 (53.8%) of the identified pathogens were MDR bacteria. According to multivariate analysis, the use of antibiotics three or more times increased the risk of infection with MDR bacteria by 4.6 times, the history of urinary tract infection in the last 6 months by 2 times, being male and over 65 years old by 3 times. Conclusion: Doctors should consider prescribing broad-spectrum antibiotics in patients with severe UTIs with a history of UTI, advanced age, male gender, and multiple antibiotic usage, even if they have a CA-UTI. Keywords: Urinary tract infection; community acquired; multidrug-resistant; male; multiple antibiotic usage; advanced age.

scholarly journals Incidence, Clinical Profile, and Risk Factors for Serious Bacterial Infections in Children Hospitalized With Fever in Ujjain, India

2020 ◽  
Author(s):  
Ashish Pathak ◽  
Radika Upadhayay ◽  
Aditya Mathur ◽  
Sunil Rathi ◽  
Cecilia Stålsby Lundborg
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Clinical Signs ◽  
Increased Risk ◽  
History Of

Abstract Background Fever is a cause for concern for both parents and the treating pediatrician and a common reason for antibiotic overuse. However, the proportion of children hospitalized for fever with serious bacterial infection (SBI) is uncertain. We aimed to evaluate the epidemiological, clinical, hematological, and biochemical risks for SBI among the children admitted with fever. Method This prospective study was conducted in a rural teaching hospital in India on consecutive children, aged 3 months–12 years, presenting with fever 100°F (37.7°C) or higher. The presence of SBI was confirmed with one of the following criteria: (a) a positive blood culture; (b) roentgenographically confirmed pneumonia with high titres of C-reactive protein; (c) a culture-confirmed urinary tract infection; (d) enteric fever diagnosed clinically in addition to either a positive blood culture or high Widal titers; and (e) meningitis diagnosed clinically in addition to either a positive blood culture or cerebrospinal fluid culture. A predefined questionnaire was filled. Results A total of 302 children were included in the study, out of which 47% (95% CI 41.4%-52.7%) presented with SBI. The factors associated with confirmed SBI in bivariate analysis were history of previous hospitalization, history of chronic illness, history of medication in the previous one week, a partially immunized child, history of common cold, moderate-grade fever, toxic look, significant lymphadenopathy, absence of BCG scar, delayed development, irritability, breathlessness, respiratory distress, poor feeding, significant weight loss, suspected urinary tract infection, hyponatremia, hypokalemia, and abnormal leucocyte count. The final generalized logistic regression model revealed partially immunized child (RR 4.26), breathlessness (RR 1.80), weight loss (RR 2.28), and suspected urinary tract infection (RR 1.95) as risk factors for the increased risk of SBI. Conclusion The study identified multiple risk factors for SBI. Pediatricians can be made aware of these risk factors. Further studies are warranted to identify age-specific risk factors for SBI because most clinicians depend on clinical signs and symptoms to identify SBI.

scholarly journals Bacteriological profile, risk factors and antimicrobial susceptibility patterns of symptomatic urinary tract infection among students of Mekelle University, northern Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guesh Gebremariam ◽  
Haftom Legese ◽  
Yemane Woldu ◽  
Tadele Araya ◽  
Kiflom Hagos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Susceptibility ◽  
Medical Attention ◽  
Bacterial Isolates ◽  
Symptomatic Urinary Tract Infection ◽  
Mekelle University ◽  
History Of

Abstract Background Bacterial infection of the urinary tract is among the common reasons for seeking medical attention in the community. Rapidly increasing antibiotic resistance of uropathogens is resulting in limited treatment options. Therefore, knowledge of the current uropathogens and their antibiotic susceptibility is important for better treatment of urinary tract infection. Methods A cross-sectional study design was conducted from February to September thirty, 2017 among students who came to Mekelle University student’s clinics with symptomatic urinary tract infection during the study period.. Mid-stream urine specimens were collected from 341individuals with suspected urinary tract infection for bacteriological identification and antimicrobial susceptibility testing. Data on socio-demographic, clinical and risk factors were also collected using a structured questionnaire. Results Among the 341 study participants, 72(21.1%) showed significant bacteriuria. Escherichia coli (48.6%), Coagulase-negative staphylococci (23%), Staphylococcus aureus (13.5%), and Klebsiella spp. (8.1%) were common bacterial isolates. Resistance to ampicillin (81–100%), amoxicillin/clavulanic acid (77–93.6%), co- trimoxazole (55 72.3%), nalidixic acid (57.4%) and tetracycline (46–55.5%) was seen by most isolates. Multidrug resistance was observed in 73% of the bacterial isolates, and 25.5% of the Gram-negative isolates were extended-spectrum beta-lactamase producers. Being female, a history of urinary tract infection, a history of catheterization and frequent sexual activity were found to be statistically associated with urinary tract infection. Conclusion Urinary tract infection is a problem among university students with a prevalence of 21.1%. All isolates have developed resistance to most of the commonly used antibiotics. Therefore, health education on the transmission and causes of urinary tract infection are recommended for the students.

Sign in / Sign up

Export Citation Format

Share Document