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解脲棒状杆菌结痂性膀胱炎的成功治疗:病例报告及文献综述

Successful treatment of Corynebacterium urealyticum encrusted cystitis: a case report and literature review.

作者信息

Pierciaccante Antonio, Pompeo Maria Elena, Fabi Flavia, Venditti Mario

机构信息

Servizio di Consulenze Internistico-Infettivologiche, III Clinica Medica, Dipartimento di Medicina Clinica, Policlinico Umberto I. Università di Roma La Sapienza, Rome, Italy.

出版信息

Infez Med. 2007 Mar;15(1):56-8.

Abstract

Encrusted cystitis is a very rare chronic inflammatory disease of the bladder characterized by precipitation and incrustation of phosphate and ammonium-magnesium salts on the vescical mucosa, caused by urinary infection due to urolithic microorganisms. Corynebacterium urealyticum or Corynebacterium group D2, a multiple antibiotic-resistant urea-splitting bacterium, is the most frequently incriminated aetiology. We report a case of a 57-year-old man affected by systemic erythematosus lupus with a long history of dysuria and suprapubic pain who underwent percutaneous nephrostomy drainage with urethral stenting for lupoid obstructive uropathy. Before the diagnosis of encrusted cystitis by Corynebacterium urealyticum was established, the patient underwent five cystoscopies to remove the plaques and multiple unsuccessful antibiotic treatment courses. Eventually the infection was definitively cured after a two-week course with intramuscular teicoplanin.

摘要

结痂性膀胱炎是一种非常罕见的膀胱慢性炎症性疾病,其特征是膀胱黏膜上有磷酸盐和磷酸铵镁盐沉淀及结痂,由尿路结石微生物引起的泌尿系统感染所致。解脲棒状杆菌或D2群棒状杆菌是一种多重耐药的尿素分解菌,是最常被认为的病因。我们报告一例57岁男性患者,患有系统性红斑狼疮,有长期排尿困难和耻骨上疼痛病史,因狼疮性梗阻性尿路病接受了经皮肾造瘘引流及尿道支架置入术。在确诊为解脲棒状杆菌引起的结痂性膀胱炎之前,该患者接受了5次膀胱镜检查以清除斑块,并进行了多次抗生素治疗但均未成功。最终,在接受了为期两周的肌肉注射替考拉宁治疗后,感染得到了彻底治愈。

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