Yoshikawa Satoshi
Department of Emergency and General Internal Medicine, Rakuwakai Marutamachi Hospital, 9-7 Jurakumawari-Matsushita-cho, Nakagyo-ku, 604-8401, Kyoto, Japan.
Urol Case Rep. 2024 Dec 10;58:102906. doi: 10.1016/j.eucr.2024.102906. eCollection 2025 Jan.
This case report describes an elderly man with a history of recurrent urinary tract infections and obstructive pyelonephritis with struvite stones caused by Proteus mirabilis. Despite appropriate antibiotic treatment, the stones increased in size, necessitating alternative therapy. This case highlights the use of ascorbic acid to lower the urine pH, which contributes to the dissolution of struvite stones. Dual-energy CT was used to differentiate the stone composition for the initiation of ascorbic acid. These findings suggest that ascorbic acid can accelerate struvite stone dissolution, and that dual-energy CT is valuable for both initial diagnosis and follow-up.
本病例报告描述了一名老年男性,有复发性尿路感染病史,因奇异变形杆菌导致梗阻性肾盂肾炎并伴有鸟粪石结石。尽管进行了适当的抗生素治疗,但结石仍增大,需要采用替代疗法。本病例突出了使用抗坏血酸降低尿液pH值,这有助于鸟粪石结石的溶解。使用双能CT鉴别结石成分以开始使用抗坏血酸治疗。这些发现表明抗坏血酸可加速鸟粪石结石溶解,且双能CT对初始诊断和随访均有价值。