Abstract
Encrusted uropathy is a rare subacute to chronic inflammatory disorder caused by infection with urease-producing bacteria, mainly Corynebacterium urealyticum. The disorder is characterized by urothelial deposition of struvite and carbonated apatite, resulting in encrustations and ulceronecrotic inflammation of the urothelium and surrounding tissues. Most commonly, encrusted uropathy is encountered in patients with predisposing conditions. The disease remains underdiagnosed. High urinary pH and negative conventional urine cultures should raise suspicion of the diagnosis. Prognosis is dependent on timely diagnosis and treatment installment, which consists of urological removal of encrustations in combination with urinary acidification and long-term antibiotic therapy.
Highlights
Frontiers in MedicineEncrusted uropathy is a rare subacute to chronic inflammatory disorder caused by infection with urease-producing bacteria, mainly Corynebacterium urealyticum
Urethritis andpyelitis are rare subacute to chronic inflammatory disorders caused by infection with urease-producing bacteria
Corynebacterium urealyticum is a gram-positive, strict aerobic, pleiomorphic, lipophilic, acid-fast, non-spore-forming, non-branching, fastidious, and multi-resistant urea-splitting rod. It is distinguished from the resembling Corynebacterium diphtheriae and Corynebacterium jeikeium due to its inability to reduce nitrates into nitrites, its asaccharolytic characteristic and its urease activity, which is highlighted by the name “urealyticum.” only first described as the cause of encrusted cystitis (EC) in 1985 [6], CU is universally recognized as the principal cause of EC and encrusted pyelitis (EP)
Summary
Encrusted uropathy is a rare subacute to chronic inflammatory disorder caused by infection with urease-producing bacteria, mainly Corynebacterium urealyticum. The disorder is characterized by urothelial deposition of struvite and carbonated apatite, resulting in encrustations and ulceronecrotic inflammation of the urothelium and surrounding tissues. Most commonly, encrusted uropathy is encountered in patients with predisposing conditions. High urinary pH and negative conventional urine cultures should raise suspicion of the diagnosis. Prognosis is dependent on timely diagnosis and treatment installment, which consists of urological removal of encrustations in combination with urinary acidification and long-term antibiotic therapy
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