Chronic Cystitis Caused by Corynebacterium urealyticum Detected by Polymerase Chain Reaction

Abstract

The case of a 73-year-old man with chronic cystitis due to Corynebacterium urealyticum was complicated by hematuria and urinary stone formation. The diagnosis was based on an amplification product obtained using polymerase chain reaction for mycobacterial species on urine and a bladder biopsy specimen. A specific 212 bp amplification fragment that did not hybridize with a Mycobacterium-specific probe was recognized. Sequence analysis of the fragment revealed Corynebacterium urealyticum. Routine urine cultures were negative, but prolonged culture on sheep blood agar led to the isolation and identification of Corynebacterium urealyticum. Identification was confirmed by polymerase chain reaction on the colonies. The patient was treated successfully with vancomycin. Integration of molecular laboratory diagnostics with conventional microbiology and pathology was synergistic for the diagnosis.

Corynebacterium urealyticum urinary tract infection in dogs and cats: 7 cases (1996–2003)

“…16 Although none of the animals in the present study were transplant recipients, the increasing frequency of renal transplant procedures and therapeutic immunosuppression in cats and dogs makes monitoring urine samples prudent. The requirement for prolonged culture has led to the development of a polymerase chain reaction-based assay to detect C urealyticum infection in humans, 17 and this technique may become useful in small animal patients also.…”

Microbiological and clinical features of Corynebacterium urealyticum: urinary tract stones and genomics as the Rosetta Stone

“…In a case of encrusted cystitis with routine urine culture being negative, DNA of C. urealyticum was detected by PCR [83]. A culture‐independent, 16S rRNA gene‐based approach has been used to identify this organism in clinical specimens.…”

“…It is thus not surprising that some patients with this condition become suicidal. Encrusted cystitis causes long‐lasting symptoms in the lower urinary tract, with frequent relapses [1,2,5,7,8,30,46,58,69,75–90]. Immunosuppression is usually less frequent than in patients with acute infections, but most patients have experienced previous bladder diseases and have undergone urological manipulations.…”

Renal failure due to encrusted cystitis and pyelitis

“…Since C. urealyticum is difficult to culture, negative urine culture cannot rule out EC and EP. Prolonged urine culture, culture of the removed stone, or DNA–polymerase chain reaction for will support the diagnosis 3,10 . Therefore, the clinician’s awareness of EC and EP is most important.…”