Renal brucelloma: A case report

Descripción del caso clínico: Paciente en contacto habitual con ganado ovino y bovino, astenia, anemia y fiebre de origen desconocido. En este contexto se realizan varias pruebas complementarias, entre ellas un TC abdominal que revela masa renal calcificada. Con la sospecha de brucelosis, tras obtenerse un resultado positivo en Rosa de Bengala, se comienza tratamiento antibiótico y se realiza nefrectomía simple derecha por lumbotomía, la pieza quirúrgica confirmó el diagnóstico con PCR positiva para Brucella Melitensis. Relevancia: Existen muy pocos casos de bruceloma renal descritos en la literatura, por ello, es importante divulgar los casos que surjan para ampliar el conocimiento sobre esta patología y su tratamiento. Implicaciones clínicas: En ocasiones las pruebas no invasivas no son suficientes para su diagnóstico y el tratamiento quirúrgico junto con la antibioterapia es de elección en la mayoría de los casos descritos en la literatura. Conclusiones: La brucelosis es una enfermedad poco frecuente pero endémica en algunas zonas. El diagnóstico suele darse en el contexto de un estudio por fiebre de origen desconocido. El tratamiento del bruceloma renal suele ser la combinación de antibioterapia y cirugía. Clinical case description: A patient in regular contact with cattle and sheep presented with asthenia, anemia, and fever of unknown origin. Among the complementary studies carried out, an abdominal CT scan revealed a calcified renal mass. Brucellosis was suspected, and after a positive Bengal Rose test, antibiotic therapy was begun. Right nephrectomy was performed through lumbotomy and the diagnosis was confirmed by the surgical specimen, with a PCR test positive for Brucella melitensis. Relevance: There are very few cases of renal brucelloma reported in the literature, thus the description of cases that arise is important to broaden the knowledge of the pathology and its treatment. Clinical implications: Noninvasive tests are often not sufficient for making the diagnosis. The surgical approach, together with antibiotic therapy, is the treatment of choice in the majority of the cases reported in the literature. Conclusions: Brucellosis is an uncommon disease, but endemic in certain areas. Diagnosis tends to be made in the context of evaluating cases of fever of unknown origin. The combination of antibiotic therapy and surgery is the usual treatment for renal brucelloma

Cateterismo ureteral iatrogeno: A propósito de dos casos y revisión de la literatura

Background: Bladder catheterization is one of the most frequent procedures in Urology, but it is not exempt from complications. Relevance: Unintentional Foley catheter placement in the ureter is a rare occurrence that can produce serious complications. Few cases are described in the literature. Case report: We present herein two cases of inadvertent Foley catheter balloon inflation in the ureter. Case 1: an 85-year-old-patient with an indwelling Foley catheter was admitted to our emergency department due to abdominal pain in the hypogastrium, dysuria, and diagnosis of septic shock from extended-spectrum beta-lactamase-producing Escherichia coli. Case 2: a 75-year-old patient underwent transurethral resection of the bladder and presented with persistent hematuria and abdominal pain in the postoperative period. Conclusion: Unintentional urinary catheter placement in the ureter is an unusual complication and a diagnostic challenge that should be suspected in the presence of abdominal pain after bladder catheterization

Metástasis testicular asincrónica de carcinoma urotelial vesical musculo invasivo

El carcinoma vesical músculo invasivo de estirpe urotelial presenta una alta probabilidad de producir metástasis, siendo los órganos más frecuentes el pulmón, hueso e hígado. Las metástasis de carcinoma urotelial de vejiga en el testículo son excepcionales. Los tumores primarios que metastatizan en testiculo son la leucemia, el prostático, el pulmonar, el melanoma y los de origen digestivo. Presentamos un caso de metástasis asincrónica de carcinoma urotelial en el testículo derecho. Las metástasis testiculares deben considerarse como un posible diagnóstico diferencial de masa gonadal en el caso de existir antecedentes de un tumor vesical musculo invasivo (TVMI). Urothelial muscle-invasive bladder carcinoma has a high probability of producing metastases, and does so most frequently to the lung, bone, and liver. Urothelial bladder carcinoma metastases to the testes are rare. The primary tumors that metastasize to the testes are leukemia, prostate cancer, lung cancer, melanoma, and gastrointestinal tumors. We present herein a case of asynchronous metastasis of urothelial carcinoma to the right testis. Testicular metastases should be considered in the differential diagnosis of a gonadal mass, when there is a history of muscle-invasive bladder cancer