 previous article in this issue | next article in this issue  |
|
Document Details : Title: Alkaline encrusted pyelitis Author(s): VAN HOOLAND S, VANDOOREN AK, LERUT E, OYEN R, MAES B Journal: Acta Clinica Belgica Volume: 60 Issue: 6 Date: 2005 Pages: 369-372 DOI: 10.2143/ACB.60.6.2050487 Abstract : Alkaline encrusted pyelitis is an infectious disease characterised by encrustations in the wall of the upper urinary tract, surrounded by severe inflammation. Destruction of native kidneys and kidney grafts may occur, resulting in end stage renal failure. Corynebacterium group D2, an urea splitting microorganism, is nearly exclusively associated with this disease. The most important predisposing factors are previous urological procedures and an immunosuppressed state. In a suggestive clinical context, diagnosis should be made with unenhanced computed tomography findings and bacteriologic isolation of the responsible microorganism. The treatment is threefold: appropriate antibiotic therapy, by preference with glycopeptides, acidifi cation of urine and chemolysis, and if needed, surgical removal of encrustations. We report the case of a patient who was diagnosed with this rare condition and could escape maintenance dialysis after correct diagnosis was made and conservative treatment was started using antibiotics and combined oral and local acidification. |
