Eggerthella lenta is a gram-positive anaerobic bacillus that has been associated with life-threatening infections. Bacteremia is always clinically significant and is mostly but not always associated with gastrointestinal disease. We present a unique case of abrupt deterioration and rapid development of septic shock secondary to periurethral abscess caused by E. lenta infection. This case highlights the atypical clinical presentation, risk factors, uncommon source of infection, challenges in therapy, and outcome of this infrequent infection. There is still a gap in the understanding of E. lenta pathogenicity, and more literature is needed to establish clear management recommendations.
Retroperitoneal fibrosis is a rare condition characterized by the presence of fibrous inflammatory tissue in the retroperitoneal structures, such as the infrarenal great vessels and ureters. We are reporting an atypical case of an alcoholic who presented with chronic back pain and abnormal liver function tests. Abdominal imaging revealed an incidental, ill-defined, abnormal soft tissue mass in the left pelvis and mild to moderate left hydroureteronephrosis. Interventional radiology (IR)-guided core biopsy reported cores of dense fibrous tissue with extensive lymphoplasmacytic infiltrates, consistent with idiopathic retroperitoneal fibrosis (IRF). The patient had a left ureteral stent placed and, subsequently, had robotic surgery for ureteral reimplantation.
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