Bilateral Xanthogranulomatous Pyelonephritis due to Staphylococcus Schleiferi: An Uncommon Presentation

Aguilar Rivera, Leonardo René y Jiménez Castillo, Raúl Alberto y Zamora López, Miguel Ángel y Ortiz Meza, Itzel Araceli y Longoria Estrada, Ulises y Purón González, Emma y Rizo Topete, Lilia María (2021) Bilateral Xanthogranulomatous Pyelonephritis due to Staphylococcus Schleiferi: An Uncommon Presentation. Arch Nephrol Urol, 4 (3). pp. 115-123.

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Resumen

Xanthogranulomatous pyelonephritis (XGP) describes a rare infectious disease with a destructive granulomatous process. The literature contains few cases of bilateral XGP and no cases due to Staphylococcus schleiferi; we diagnosed it with the advance at imaging and bacterial identification systems technology. This is a case of a 22-year-old female at our emergency department complaining of abdominal pain, nausea, emesis, dyspnea of 3 weeks. Medical history included Chronic Kidney Disease (CKD) treated with Peritoneal dialysis and history of recurrent urinary tract infection. On examination, we found signs of septic shock and suprapubic tenderness. No flank or renal mass found on examination. Tomography (CT) scan showed bilateral kidney enlargement with pyelocaliceal dilatation due to stones obstructing ureteral union; presence of gas on left kidney´s renal pelvis and an abscess in the posterior pararenal space. We diagnosed Bilateral XGP and emphysematous pyelitis, initiated boardspectrum antibiotic and perform urgent right nephrostomy and left nephrectomy. The urinary, blood and renal tissue culture identified pathogenic agents (Escherichia coli and Staphylococcus schleiferi) and antibiotic treatment was de-escalated. After two weeks of treatment, she recovered of an acute on chronic renal failure (ACRF) remaining with 24ml/min/1.73m2 of GFR (stage IV of CKD) and was discharged from hospital.

Tipo de elemento: Article
Materias: R Medicina > RC Medicina Interna, Psiquiatría, Neurología
Divisiones: Medicina
Usuario depositante: Editor Repositorio
Creadores:
CreadorEmailORCID
Aguilar Rivera, Leonardo Renéreneaguilarr10@gmail.comorcid.org/0000-0001-9808-5425
Jiménez Castillo, Raúl Albertoraulalbertojc10@gmail.comNO ESPECIFICADO
Zamora López, Miguel Ángelmiguelzamoralopez91@gmail.comorcid.org/0000-0002-6234-9334
Ortiz Meza, Itzel AraceliNO ESPECIFICADONO ESPECIFICADO
Longoria Estrada, UlisesNO ESPECIFICADONO ESPECIFICADO
Purón González, EmmaNO ESPECIFICADONO ESPECIFICADO
Rizo Topete, Lilia MaríaNO ESPECIFICADONO ESPECIFICADO
Fecha del depósito: 05 Mar 2023 13:47
Última modificación: 18 Mayo 2023 19:02
URI: http://eprints.uanl.mx/id/eprint/24856

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