Case 167: Alkaline-encrusted Pyelitis

Abstract

Imaging Findings US of the kidneys revealed mild left hydronephrosis and bilateral renal calyceal echogenicities with shadowing. These were initially thought to be calculi (Fig 1). Unenhanced CT of the abdomen and pelvis revealed mild bilateral hydroureter and hydronephrosis, with curvilinear calcifi cations involving the urothelium of the renal pelves and calyces (Fig 2). These CT fi ndings were not seen at CT performed approximately 1 year previously. On the basis of these radiologic fi ndings, a presumptive diagnosis of alkaline-encrusted pyelitis was made.

Alkaline-Encrusted Pyelitis in a Renal Allograft

“…It is known to be multidrug resistant but universally sensitive to glycopeptides 15 . Use of vancomycin is frequently reported 3, 8, 11, 16. The duration of treatment is adjusted according to disease severity and response but is often up to 4 weeks 2, 9…”