Fatal septic shock caused by Corynebacterium D2

Objectives To examine the clinical signs, laboratory findings, possible predisposing factors, antimicrobial sensitivity and outcomes of dogs and cats diagnosed with urinary tract infection caused by Corynebacterium urealyticum. Materials and Methods Retrospective, observational study of dogs and cats that were diagnosed with urinary tract infection caused by C. urealyticum. Results This report concerns a total of 11 dogs and 10 cats. All cats had a history of urethral catheterisation, and six cats had undergone urological surgery before diagnosis of this specific infection. Dogs had history of neurogenic urinary incontinence (n=5), urethral catheterisation (n=4), urological surgery (n=4), lower urinary tract disease (n=2) or prostatic disease (n=1). In seven animals, previous urine culture was negative. Median urine pH was 8.6 (interquartile range 7.5 to 9), and 19 animals had pyuria and struvite crystalluria. Encrusted cystitis was diagnosed by abdominal ultrasound in nine animals. All but one isolate were resistant to at least three antimicrobial classes. Thirteen isolates were sensitive to tetracyclines. There was bacterial and clinical resolution of the infection in nine dogs and seven cats. Two animals died from sepsis and two cats were euthanased because of clinical deterioration. Clinical Significance Urinary tract infection caused by C. urealyticum should be suspected in animals with pre‐existing urinary disorders, especially if urine is alkaline and there is struvite crystalluria, negative routine urine culture and encrusted cystitis.

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“…Nevertheless, septic shock (Audard et al . ) and death due to encrusted pyelitis (Chung et al . ) have also been described.…”

Section: Discussionmentioning

confidence: 99%

“…Outcomes in human patients with CU-UTI receiving adequate treatment are usually favourable (Meria et al 1998). Nevertheless, septic shock (Audard et al 2003) and death due to encrusted pyelitis (Chung et al 2003) have also been described. Furthermore, cases of CU bacteraemia and endocarditis have been reported (Fernández-Natal et al 2001).…”

Section: Discussionmentioning

confidence: 99%

Clinical description of Corynebacterium urealyticum urinary tract infections in 11 dogs and 10 cats

Maurey

Boulouis

Canonne-Guibert

et al. 2019

J of Small Animal Practice

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“…Another serious chronic infection is encrusted pyelitis [69,82,85,86,91–98], which has been mainly described in renal transplant recipients [69,82,85,86,93–95], but also in native kidneys of patients with urological diseases [95–97]. It is a severe event that can destroy the renal graft of transplanted patients [69,82,85,86,94,98].…”

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confidence: 99%

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

Soriano

Tauch

2008

Clinical Microbiology and Infection

100

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Corynebacterium urealyticum, formerly known as coryneform CDC group D2, was first recognized to be involved in human infections 30 years ago. It is a slow-growing, lipophilic, asaccharolytic and usually multidrug-resistant organism with potent urease activity. Its cell wall peptidoglycan, menaquinone, mycolic and cellular fatty acid composition is consistent with that of the genus Corynebacterium. DNA-DNA hybridization studies and 16S rDNA sequencing analysis have been used to determine the degree of relatedness of C. urealyticum to other corynebacterial species. The genome of the type strain consists of a circular chromosome with a size of 2 369 219 bp and a mean G + C content of 64.2%, and analysis of its genome explains the bacterium's lifestyle. C. urealyticum is a common skin colonizer of hospitalized elderly individuals who are receiving broad-spectrum antibiotics. It is an opportunistic pathogen causing mainly acute cystitis, pyelonephritis, encrusted cystitis, and encrusted pyelitis. More infrequently, it causes other infections, but mainly in patients with urological diseases. Infections are more common in males than in females, and treatment requires administration of antibiotics active against the organism in vitro, mainly glycopeptides, as well as surgical intervention, the latter mostly in cases of chronic infection. Mortality directly associated with infection by this organism is not frequent, but encrusted pyelitis in kidney-recipient patients may cause graft loss. The outcome of infection by this organism is reasonably good if the microbiological diagnosis is made and patients are treated appropriately.

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“…These findings suggest that EC has a slowly progressive course over several months. Mortality 4‐6 or loss of renal function 7 due to a delay in diagnosis has been reported. If adequately diagnosed and treated, the prognosis is considered favorable 8 .…”

Section: Discussionmentioning

confidence: 99%

Renal failure due to encrusted cystitis and pyelitis

et al. 2020

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Abbreviations & Acronyms CRP = C-reactive protein CT = computed tomography EC = encrusted cystitis EP = encrusted pyelitis PNS = percutaneous nephrostomy PSL = prednisolone TUCL = transurethral cystolithotripsy WBC = white blood cell Correspondence: KatsuhiroIntroduction: Encrusted cystitis and pyelitis are a rare urinary tract infection characterized by mold-like calcification of collecting system. Here, we show a case of encrusted cystitis proceeding to pyelitis during a 1-month delay in diagnosis. Case presentation: A 73-year-old man developed hematuria and pain during micturition while he was being treated for granulomatosis with polyangiitis and lung abscess. Cystoscopy revealed calcification of the bladder wall, and an initial diagnosis of a bladder stone was made. While awaiting surgery, the bladder wall calcification extended to the renal pelvis on both sides, with renal failure. He underwent bilateral nephrostomy replacement and bladder irrigation with Solita T1 and was administered intravenous vancomycin. Calcification almost regressed after 4 weeks of treatment. Conclusion: Encrusted cystitis and pyelitis should be suspected if the patient shows alkaline urine and urothelial mucosa calcification. Appropriate treatment includes antibiotics, urine drainage, and chemolysis by bladder irrigation.We report a case of EC proceeding to pyelitis with renal failure during a 1-month delay in diagnosis. Early suspicion of the disease is necessary if the patient shows alkaline urine and urothelial mucosa calcification.

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Fatal septic shock caused by Corynebacterium D2

Abstract: Corynebacterium D2 is known to cause chronic inflammation of the bladder and proximal urinary tract but can also cause severe septic shock in immunocompetent patients.

Cited by 16 publications

References 10 publications

Clinical description of Corynebacterium urealyticum urinary tract infections in 11 dogs and 10 cats

Clinical description of Corynebacterium urealyticum urinary tract infections in 11 dogs and 10 cats

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

Renal failure due to encrusted cystitis and pyelitis

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