NDT Advance Access published online on May 8, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn243
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Encrusted cystitis by Corynebacterium urealyticum: a case report with novel insights into bladder lesions
1 Nephrology Unit and Kidney Histomorphology and Molecular Biology Laboratory, Department of Medical and Surgical Sciences 2 Urology Unit 3 Histology, Microbiology and Medical Biotechnology Department 4 Department of Medical-Diagnostic Sciences, Institute of Pathological Anatomy, University of Padova, Padova, Italy
Correspondence and offprint requests to: Dorella Del Prete, Nephrology Unit, Department of Medical and Surgical Sciences, University of Padova, via Giustiniani 2, 35128 Padova, Italy. Tel: +39-049-8212146; Fax: +39-049-8212151; E-mail: dorella.delprete@unipd.it
Keywords: Corynebacterium urealyticum; cystitis; encrustation; osteogenic markers
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| Background |
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Corynebacterium urealyticum (CU) (formerly Corynebacterium group D2) is a gram-positive bacillus with a strong urease activity that can infect the lower (acute or chronic cystitis) and upper (pyelonephritis and encrusted pyelitis) urinary tract [1]. CU is a commensal skin organism that an estimated 12% of healthy individuals carry and it has been isolated in 30% of hospitalized patients. CU converts urea into ammonia, creating alkaline urine, which precipitates struvite and calcium phosphate crystals, forming stones and encrustations on the infected mucosa [2].
Prolonged vesical and ureteral catheterization is considered the most important risk factor for developing encrusted cystitis (EC) and encrusted pyelitis (EP); these procedures not only carry CU or other urea-splitting micro-organisms into the urinary tract, but may also create conditions, e.g. urothelial trauma, that increase the
| Case report |
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| Discussion |
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