Renal vein thrombosis complicating severe acute pyelonephritis with renal abscesses and associated bacteraemia caused by extended-spectrum beta-lactamase producing Escherichia coli

Abstract

Acute pyelonephritis might be complicated by the formation of renal and perirenal abscesses and very rarely by renal vein thrombosis, which is a life-threatening condition. The main causative agents of acute pyelonephritis are enterobacteriaceae with the incidence of extended-spectrum beta-lactamase (ESBL)-producing strains increasing worldwide. We present the case of a 71-year-old Greek man with history of diabetes mellitus and recent hospitalization, who suffered from severe pyelonephritis with renal abscesses formation and associated bacteraemia caused by ESBL-producing Escherichia coli, complicated by extensive thrombosis of the ipsilateral renal vein and its branches, protruding also in the inferior venal cava. Our patient was effectively treated with anticoagulants and targeted antibiotic therapy, respectively, consisted of low molecular weight heparin transitioned to oral acenocoumarol for 3 months and 2-week course of intravenous meropenem followed by oral fosfomycin for additional 3 weeks as quidded by clinical and computed tomographic follow-up. In conclusion, in complicated urinary infections, caused by ESBL-producing enterobacteriaceae, oral fosfomycin might represent an effective option for step-down therapy of carbapenems, allowing the shortness of the duration of patient's hospitalization and carbapenem use.

Renal Vein Thrombosis Secondary to Pyelonephritis: Targeting a Thrombo-Inflammatory Entity

“…To date, only a small number of similar cases have been documented in the literature. The clinical characteristics of these patients are described in Table 2 [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

“…To date, only a small number of similar cases have been documented in the literature. The clinical characteristics of these patients are described in Table 2 [10][11][12][13][14][15][16][17][18][19][20]. Most cases involved females (63.6%), with a median patient age of 49.7 years, while diabetes mellitus was present in four patients (Table 2).…”

Renal abscess complicating acute pyelonephritis in children: Two cases report and literature review

“…Estimates show that children with renal abscess often have abnormal ureters (41.2%), renal dysplasia or nonfunctional kidneys (17.6%), vesicoureteral reflux (11.8%), and other genitourinary system abnormalities. [ 1 , 10 ] Moreover, 23.5% of these children usually have a history of repeated lower UTIs, [ 22 ] suggesting that these events might predispose to developing renal abscesses. We presented case two with a history of UTIs, and 2 renal abscesses.…”

Loeselia mexicana: Antioxidant and antimicrobial properties by Soxhlet differential extraction

“…The association with respiratory, gastrointestinal, and topical pathologies associates the antimicrobial use of L. mexicana, since these pathologies are mainly responses to a bacterial infection such as A. baumanni (8), S. aureus (9)(10)(11)(12), E. coli (13,14), E. fecalis (9,(15)(16)(17), S. saprophyticus (18)(19)(20), S. typhimurium (21), E. Coli BLEE (14,22), M. morganii (23), among others, being necessary to establish if there is an antimicrobial effect. While topical use as a healing agent is associated with antioxidant effects to reduce the oxidative process (24), the other interesting study approach is to establish a correlation between the traditional uses of L. mexicana and a scientific basis, for which differential extraction studies allow establishing what type of metabolites are associated with biological activity and choose the appropriate extraction method.…”