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Urinary tract infection and renal abscess complicated by duodenal obstruction : case reportA 42-year-old woman developed urinary tract infection and renal abscess complicated by duodenal obstruction during treatment with canagliflozin for type 2 diabetes mellitus.The woman presented with fever, right flank pain, nausea, vomiting and diarrhoea. She experienced weight loss of 20kgs in last month. She also reported of urinary incontinence and recurrent urinary tract infections. Her medical history was significant for type 2 diabetes mellitus and was on canagliflozin [dosages and routes not stated] along with various other medications. On examination, her heart rate was 100 bpm, BP 120/90mm Hg, respiratory rate 20 breaths/min and she was morbidly obese. Following admission, she did not pass stool or gas. Her laboratory tests demonstrated elevated WBC and Creactive protein levels. A urinalysis revealed infection. An abdominal radiograph exhibited a short air-fluid level in the mesogastrium, without signs of obstruction. An abdomen CT revealed a fluid collection with enhancing wall probably originating from the right kidney's upper pole, with concomitant infiltration which involved the duodenum and caused its obstruction. She was diagnosed with renal abscess complicated by duodenal obstruction [duration of treatment to reactions not stated].The woman underwent a CT guided drainage. The culture test of urine and abscess revealed extended spectrum betalactamases producing Escherichia coli. She was started on treatment with meropenem and amikacin. There was an improvement in her condition with a decrease in fever and volume of the pus drained. Subsequently, her diet and oral fluids were restored. Drainage was removed. Her treatment with canagliflozin was changed to linagliptin. Eventually, she was discharged home.Author comment: "Diabetes is one of the most common predisposing states to genitourinary infections, and their risk may be augmented by use of gliflozins". "In the presented case, obesity, poor diabetes control, gliflozin, and prolonging infections led to duodenal obstruction, which is an uncommon manifestation of renal abscess."Gierlikowski W, et al. Renal abscess complicated by duodenal obstruction in a patient with obesity and type 2 diabetes mellitus treated with gliflozin.
Urinary tract infection and renal abscess complicated by duodenal obstruction : case reportA 42-year-old woman developed urinary tract infection and renal abscess complicated by duodenal obstruction during treatment with canagliflozin for type 2 diabetes mellitus.The woman presented with fever, right flank pain, nausea, vomiting and diarrhoea. She experienced weight loss of 20kgs in last month. She also reported of urinary incontinence and recurrent urinary tract infections. Her medical history was significant for type 2 diabetes mellitus and was on canagliflozin [dosages and routes not stated] along with various other medications. On examination, her heart rate was 100 bpm, BP 120/90mm Hg, respiratory rate 20 breaths/min and she was morbidly obese. Following admission, she did not pass stool or gas. Her laboratory tests demonstrated elevated WBC and Creactive protein levels. A urinalysis revealed infection. An abdominal radiograph exhibited a short air-fluid level in the mesogastrium, without signs of obstruction. An abdomen CT revealed a fluid collection with enhancing wall probably originating from the right kidney's upper pole, with concomitant infiltration which involved the duodenum and caused its obstruction. She was diagnosed with renal abscess complicated by duodenal obstruction [duration of treatment to reactions not stated].The woman underwent a CT guided drainage. The culture test of urine and abscess revealed extended spectrum betalactamases producing Escherichia coli. She was started on treatment with meropenem and amikacin. There was an improvement in her condition with a decrease in fever and volume of the pus drained. Subsequently, her diet and oral fluids were restored. Drainage was removed. Her treatment with canagliflozin was changed to linagliptin. Eventually, she was discharged home.Author comment: "Diabetes is one of the most common predisposing states to genitourinary infections, and their risk may be augmented by use of gliflozins". "In the presented case, obesity, poor diabetes control, gliflozin, and prolonging infections led to duodenal obstruction, which is an uncommon manifestation of renal abscess."Gierlikowski W, et al. Renal abscess complicated by duodenal obstruction in a patient with obesity and type 2 diabetes mellitus treated with gliflozin.
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