Penicillin G-induced hemorrhagic cystitis: a case and review of the literature

Kim, Min Kyung; Kang, Chang Kyung; Kim, Min Jae; Jun, Kang Il; Lee, Yong Seuk; Jeong, Seong Jin; Song, Kyoung Ho

doi:10.3904/kjim.2013.28.6.743

Cited by 11 publications

(10 citation statements)

References 5 publications

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“…As such states require therapy with a large amount and long duration of PCG, possible drug-induced side effects need careful monitoring. Three previously reported adult HC cases induced by PCG [3,[6][7][8] involved IE treated with aminoglycoside [6][7][8]. In those situations that require a large amount of PCG for a long duration, a routine urinary qualitative test may be helpful, especially in pediatric cases, to minimize the delay of noticing the onset of HC, as in this case.…”

Section: Discussionmentioning

confidence: 77%

“…In this case, the time to HC recovery was relatively rapid when we considered that 1-3 weeks were required for PCG-induced HC in an adult [3]. Although the precise mechanism of penicillin-induced HC is not known, a penicillin-related immune reaction may damage the bladder mucosa [3], or penicillin itself or metabolites may be directly toxic to the bladder. Because most patients develop symptoms after prolonged exposure to penicillin, direct bladder irritation is possible.…”

Section: Discussionmentioning

confidence: 98%

“…As HC can be serious and may require invasive diagnostic evaluations, recognizing the possible causes is of clinical importance. Penicillin G (PCG) is an antibiotic to treat various bacterial infections, including pneumonia, sepsis, and endocarditis, caused by bacteria such as staphylococci and streptococci [2].To our knowledge, HC induced by PCG has rarely been reported in adults [3] but not in children. Herein, we report a clinically-diagnosed pediatric case of PCG-induced HC.…”

Section: Introductionmentioning

confidence: 99%

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First Pediatric Case of Clinically-Diagnosed Penicillin G–Induced Hemorrhagic Cystitis

Hayashi¹,

Urushihara²,

Ishido³

et al. 2022

Cureus

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Hemorrhagic cystitis is a diffuse inflammatory disease of the urinary bladder associated with macrohematuria. Several cases of hemorrhagic cystitis caused by penicillin G have been reported in adults but not children. Here we describe the first pediatric case of clinically-diagnosed penicillin G-induced hemorrhagic cystitis. The patient was a 9-year-old boy with a ventricular septal defect, chromosomal abnormalities, and infective endocarditis caused by Abiotrophia defectiva. After approximately four weeks of penicillin G administration, he had a culture-negative major hemorrhage with a clot. The hematuria resolved one week after penicillin G discontinuation, and a drug lymphocyte stimulation test for penicillin G was positive. In conclusion, penicillin G can also induce hemorrhagic cystitis in children. When large doses of penicillin G are used for long periods in adults or children, the patient should be monitored for hemorrhagic cystitis.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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First Pediatric Case of Clinically-Diagnosed Penicillin G–Induced Hemorrhagic Cystitis

Hayashi¹,

Urushihara²,

Ishido³

et al. 2022

Cureus

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“…A synthetic β-lactam caused urothelial hyperplasia in rats but scientist suggested that chemical is not toxic to human [87]. In a case study, it has been reported that penicillin-G induced haemorrhagic cystitis, but the patient recovered in 8 days [88]. Some of the β-lactams toxicity grades and possible adverse efects were shown in Table 1.…”

Section: Toxicity Of β-Lactam Antibioticsmentioning

confidence: 99%

Toxicity of β-Lactam Antibiotics: Pathophysiology, Molecular Biology and Possible Recovery Strategies

Bozcal¹,

Dagdeviren²

2017

Poisoning - From Specific Toxic Agents to Novel Rapid and Simplified Techniques for Analysis

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Beta (β)-lactam antibiotics are wide-spectrum antibiotics used for various bacterial infections. The aim of this chapter is to summarize the knowledge about the toxicity of β-lactam antibiotics and issues associated to their inappropriate use. This review has highlighted that β-lactam antibiotics are a group of products that have a chemical structure characterized by a β-lactam ring and are one of the most common antibacterial agents. However, due to the inappropriate use including abuse and misuse, resistance to the β-lactam antibiotics is currently a global crisis. Moreover, even when used appropriately, they have been linked to triggering allergic reactions like urticaria, bronchoconstriction, also severe conditions like immune-mediated haemolytic anaemia and intravascular haemolysis. It is known that some β-lactam antibiotics are neurotoxic, some are nephrotoxic, some are genotoxic and some are toxic to urogenital system. Several factors are involved in the occurrence of toxic efects including the dosage and renal status. Several strategies are possible to overcome β-lactam antibiotics-triggered toxicity, including rational prescribing, substitution combination and phage therapy which seems promising. Public health education for clinical teams and patients is essential in ensuring that this group of antibiotics are retained in therapeutics.

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“…We read the article by Kim et al [ 1 ] with great interest. Drug-induced hemorrhagic cystitis is a rare complication, especially during antibiotic therapy.…”

mentioning

confidence: 99%