1 research outputs found
Bilateral Xanthogranulomatous Pyelonephritis due to Staphylococcus Schleiferi: An Uncommon Presentation
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麓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