scholarly journals Xanthogranulomatous pyelonephritis infected with the Providencia stuartii: a case report and literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhunan Xu ◽  
Tong Cai ◽  
Xuebao Zhang ◽  
Jitao Wu ◽  
Chu Liu
Keyword(s):  
Radical Nephrectomy ◽  
Chronic Inflammatory Disease ◽  
Laser Lithotripsy ◽  
Xanthogranulomatous Pyelonephritis ◽  
Case Presentation ◽  
E Coli ◽  
Holmium Laser Lithotripsy ◽  
Pseudomonas Species ◽  
Ureteral Stenting ◽  
Providencia Stuartii

Abstract Background Xanthogranulomatous pyelonephritis (XGP) is a rare and severe chronic inflammatory disease of the renal parenchyma, which is most commonly associated with super-infections by bacteria such as E. coli, Proteus mirabilis, and occasionally Pseudomonas species. Case presentation Herein, we present a rare case of a patient with XGP infected with Providencia stuartii. Initially, the patient refused nephrectomy and underwent holmium laser lithotripsy and right ureteral stenting, followed by meropenem treatment of 7 days. Relapse occurred in the third month after discharge from the hospital, due to which she underwent a radical nephrectomy. Discussion The diagnosis of XGP is confirmed by histopathology. The standard treatment for XGP is antibiotic therapy and radical nephrectomy, but partial nephrectomy may be appropriate in select cases.

Intermammary Hidradenitis Suppurativa: Considerations on a Unique Presentation

2021 ◽  
pp. 1-4
Author(s):  
Ana Luísa João ◽  
Nélia Cunha ◽  
Joana Cabete
Keyword(s):  
Surgical Approach ◽  
Inflammatory Disease ◽  
Pilonidal Sinus ◽  
Hidradenitis Suppurativa ◽  
Chronic Inflammatory Disease ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Case Presentation ◽  
Overweight Women

Introduction: Hidradenitis suppurativa (HS) is a potentially disabling chronic inflammatory disease. The intermammary location, not clearly specified in the usual phenotypic classifications, entails significant functional and cosmetic compromise. Case Presentation: Eleven cases of predominantly intermammary disease with multiple fistulization and disfiguring scarring were observed at our Department between January 2016 and March 2020. They were young (mean age = 22 years) obese or overweight women, in which the medical-surgical approach has led to variable results. Discussion/Conclusion: Intermammary HS possibly represents a unique phenotypic presentation, likely to be fistulizing and severe. We believe that anatomo-functional considerations, which can be paralleled to pilonidal sinus disease, contribute to its pathophysiology and striking appearance, and further emphasize the importance of multidisciplinary endeavor to reduce the morbidity associated with this seemingly overlooked location.

scholarly journals Effects of irrigation fluid temperature during flexible ureteroscopic holmium laser lithotripsy on postoperative fever and shivering: a randomized controlled trial

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yue He ◽  
You-Gang Feng ◽  
Jun He ◽  
Bo Liang ◽  
Ming-Dong Jiang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Fluid Temperature ◽  
Postoperative Fever ◽  
Irrigation Fluid ◽  
Suspected Infection ◽  
Randomized Controlled ◽  
Holmium Laser Lithotripsy

Abstract Background Flexible ureteroscopic holmium laser lithotripsy is used to treat urinary tract calculi, but postoperative complications include shivering, fever and infection. To investigate the effects of irrigation fluid temperature on postoperative complications. Methods This randomized controlled trial included 120 consecutive patients undergoing flexible ureteroscopic holmium laser lithotripsy at the Urology Department, Suining Central Hospital, Sichuan, China between January 2017 and July 2019. Patients were randomized 1:1:1 into three groups (17 °C, 27 °C or 37 °C). Primary outcome was fever incidence (body temperature > 37.5 °C) within 48 h after surgery. Secondary outcomes included shivering incidence during recovery from anesthesia, white blood cell count (WBC), serum procalcitonin (PCT) and incidence of suspected infection (temperature > 38.5 °C and PCT > 0.5 µg/L). Results There were 108 patients, (17 °C group, n = 36; 27 °C group, n = 35; 37 °C group, n = 37), received flexible ureteroscopic holmium laser lithotripsy and analyzed. Age, gender distribution, body mass index, ASA grade, stone burden, preoperative creatinine, preoperative core temperature and irrigation fluid volume did not differ significantly between groups. 17 °C, 27 °C and 37 °C groups exhibited significant differences in the incidences of postoperative fever (38.9% vs. 17.1% vs. 13.5%) and shivering (22.2% vs. 5.7% vs. 2.7%) (p < 0.05 for all pairwise comparisons). There was no significant difference of WBC, PCT and incidence of suspected infection in 37 °C or 27 °C group compared with 17 °C group. One case each of flash pulmonary edema and bleeding occurred in 37 °C group. Conclusion Warming the irrigation fluid can reduce the incidence of postoperative fever and shivering, but further studies are needed to determine the optimal temperature. Trial registration The trial was registered at the Chinese Clinical Trials Registry and allocated as ChiCTR2000031683. The trial was registered on 07/04/2020 and this was a retrospective registration.

scholarly journals Delayed hypersensitivity reaction to orodispersible budesonide in a case with eosinophilic esophagitis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Caroline Michèle Andrist ◽  
Lukas Jörg ◽  
Thomas Greuter ◽  
Anna Gschwend ◽  
Alex Straumann ◽  
...  
Keyword(s):  
Hypersensitivity Reaction ◽  
Eosinophilic Esophagitis ◽  
Systemic Reaction ◽  
Chronic Inflammatory Disease ◽  
Delayed Hypersensitivity ◽  
Caucasian Woman ◽  
Case Presentation ◽  
Commercial Test ◽  
Delayed Hypersensitivity Reaction ◽  
Subsequent Intake

Abstract Background Eosinophilic esophagitis (EoE) is a chronic inflammatory disease that has been known since the early 1990s. Swallowed topical corticosteroids (STC) belong to the therapeutic cornerstones. We describe a delayed hypersensitivity reaction to Jorveza®, a newly developed orodispersible budesonide tablet licensed for the treatment of eosinophilic esophagitis. Case presentation A 32-year-old Caucasian woman with EoE was newly treated with Jorveza®. Hours after the first intake, she felt a “strange pruritus” in the throat. This sensation worsened with each subsequent intake. On day 4 she developed oral mucosal symptoms (paresthesia of the tongue, sore and an itchy throat). Intraoral, throat and facial swellings, but no systemic reaction were observed. Patch testing using two commercial test series as well as the orodispersible budesonide tablet revealed a strong sensitization, proving a T cell mediated allergy to budesonide. Conclusions Orodispersible budesonide is increasingly prescribed for the treatment of eosinophilic esophagitis. The development of oropharyngeal symptoms after initiating should alert the treating physician to the possibility of a hypersensitivity reaction.

Size Distribution of Fragments by High-power Holmium Laser Lithotripsy in MiniPCNL with Suction

2021 ◽  
Vol 22 (12) ◽  
Author(s):  
Naveen K. Reddy ◽  
Abhijit P. Patil ◽  
Gopal R. Tak ◽  
Darshit Shah ◽  
Abhishek G. Singh ◽  
...  
Keyword(s):  
Size Distribution ◽  
High Power ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Holmium Laser Lithotripsy

Species interactions in mixed-community crystalline biofilms on urinary catheters

2007 ◽  
Vol 56 (11) ◽  
pp. 1549-1557 ◽  
Author(s):  
Sarah M. Macleod ◽  
David J. Stickler
Keyword(s):  
Urinary Tract ◽  
Species Interactions ◽  
The Other ◽  
Experimental Investigations ◽  
Crystal Formation ◽  
Urinary Catheters ◽  
E Coli ◽  
Pure Cultures ◽  
Providencia Stuartii

Previous experimental investigations of the crystalline biofilms that colonize and block urinary catheters have focussed on their formation by pure cultures of Proteus mirabilis. In the urine of patients undergoing long-term catheterization, P. mirabilis is commonly found in mixed communities with other urinary tract pathogens. Little is known about the effect that the other species have on the rate at which P. mirabilis encrusts catheters. In the present study, a set of data on the nature of the bacterial communities on 106 catheter biofilms has been analysed and it was found that while species such as Providencia stuartii and Klebsiella pneumoniae were commonly associated with P. mirabilis, when Escherichia coli, Morganella morganii or Enterobacter cloacae were present, P. mirabilis was rarely or never found. The hypothesis that the absence of P. mirabilis from some biofilm communities could be due to its active exclusion by other species has also been examined. Experiments in laboratory models showed that co-infection of P. mirabilis with M. morganii, K. pneumoniae or E. coli had no effect on the ability of P. mirabilis to encrust and block catheters. Co-infection with Ent. cloacae or Pseudomonas aeruginosa, however, significantly increased the time that catheters took to block (P <0.05). The growth of Ent. cloacae, M. morganii, K. pneumoniae or E. coli in the model for 72 h prior to superinfection with P. mirabilis significantly delayed catheter blockage. In the case of Ent. cloacae, for example, the mean time to blockage was extended from 28.7 h to 60.7 h (P ≤0.01). In all cases, however, P. mirabilis was able to generate alkaline urine, colonize the biofilms, induce crystal formation and block the catheters. The results suggest that although there is a degree of antagonism between P. mirabilis and some of the other urinary tract organisms, the effects are temporary and whatever the pre-existing urinary microbiota, infection with P. mirabilis is thus likely to lead to catheter encrustation and blockage.

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