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How Do You Diagnose Recurrent Urinary Tract Infections and Confirm the Diagnosis?
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Hoon Choi, Jae Hyun Bae
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Urogenit Tract Infect 2016;11(3):93-96. Published online December 31, 2016
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 Abstract
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- Recurrent urinary tract infections (UTIs) are the most prevalent conditions affected mainly by reinfection by the same bacteria in young women with no functional or anatomic problem. Recurrent UTIs present both storage (dysuria, irritative etc.) and voiding symptoms. For example, frequency subsequently followed by sexual intercourse is a powerful predictor of recurrent UTI. In patients with morbid situations or other factors, recurrent complicated infections or sepsis may be aggravated. Escherichia coli is the most common organism responsible for UTIs, but Pseudomonas, Proteus, Klebsiella, and other organisms are also frequent, particularly, in patients higher risk of complicated infections. Urine culture is not often needed to diagnose typical uncomplicated infection. Generally, urine culture with more than 102 colony-forming units/ml is used to diagnose UTIs in symptomatic patients. Recurrent UTIs could be managed with several techniques with the help of urine culture and by imaging studies when suspicious of anatomical abnormalities.
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Changes of Bacterial Resistant Pattern in Adult Acute Epididymitis at a Tertiary Hospital in Recent Ten Years
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Jong Jin Park, Jong Wook Kim, Jae Hyun Bae, Du Geon Moon, Mi Mi Oh
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Korean J Urogenit Tract Infect Inflamm 2014;9(1):39-43. Published online April 30, 2014
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- Purpose
We conducted a retrospective study to investigate causative bacteria of adult epididymitis and their characteristics and resistance in the recent 10 years at a tertiary hospital.
Materials and Methods: We reviewed the medical records of 121 patients who were diagnosed with acute epididymitis from 2002 to 2012. Diagnosis was based on symptoms, physical examination, and ultrasonography. We analyzed causative organisms and changes of antibiotic resistance pattern according to time course in the recent 10 years.
Results: The most commonly detected bacteria were Pseudomonas aeruginosa and Escherichia coli. Fluouroquinolone resistance has emerged since 2006 and 50% of the patients have resistance to fluouroquinolones.
Conclusions: Quinolone resistance composes a major proportion of the causative organism. Therefore, while according to the guidelines, fluoroquinolone may be the first response for elderly men, we recommend that antibiotic resistance should be considered if fever persists, and other antibiotics could be included.
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Urothelial Changes by Inflammation in Interstitial Cystitis/Painful Bladder Syndrome
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Hoon Choi, Jae Hyun Bae
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Korean J Urogenit Tract Infect Inflamm 2013;8(2):83-89. Published online October 31, 2013
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- Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease. Symptoms of IC are often exacerbated by bladder filling and are associated with various urinary symptoms. IC is diagnosed by exclusion steps for differentiation from other confusable diseases. The pathophysiology and etiology of BPS/IC is not completely understood. IC is generally assumed to involve changes in the bladder wall as well as alterations in both structural abnormality of pain processing and its modulation. Alterations of the bladder wall at the molecular and structural levels in urothelium along with their adjacent structures have been observed in human patients. Bladder nerves, urothelial cells, and smooth muscles are likely to play an important role through active communication with the immune and inflammatory systems. This review provides recent information on patients with PBS/IC and their abnormalities within the bladder.
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Outbreaks and Seasonal Variation of Mumps Orchitis: Report of Multicenter Data in Korea
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Hoon Choi, Jae Hyun Bae, Seung Il Jung, Seung Ki Min, Tae Hyung Kim, Yong Gil Na, Gil Ho Lee
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Korean J Urogenit Tract Infect Inflamm 2013;8(1):43-46. Published online April 30, 2013
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- Purpose: Mumps is an infectious viral disease that often results in painful swelling of testis preceded by parotitis. We report multicenter data on mumps orchitis from five community hospitals.
Materials and Methods: From January 2011 to December 2012, 98 patients diagnosed with acute mumps orchitis were treated at five community hospitals in different districts of Korea. As a report on an outbreak of mumps orchitis, age, bilaterality, monthly occurrence frequency, and vaccination status were recorded retrospectively.
Results: The mean age of the 98 patients was 19.7 (range from 10 to 38) years old. Age distribution of patients included 60 teens (61.2%), 31 in their twenties (31.6%), and seven in their thirties (7.2%). No evidence of a previous mumps vaccination was found in medical records from six patients (6.1%), and the vaccination status of one patient was unknown. Bilateral orchitis was noted in eight patients (8.2%), and 90 patients (91.8%) had unilateral orchitis. Right-sided orchitis was noted in 50 patients (51.0%), and left-sided orchitis was noted in 40 patients (40.8%). Autumn (September to November) was the most prevalent season, with 35 outbreaks (35.7%). Seasonal outbreaks occurred in 13 patients (13.2%) in spring (3rd- 5th), 24 patients (24.7%) in summer (6th-8th), and 26 patients (26.4%) in winter (12th-2nd).
Conclusions: In spite of continued vaccination, mumps orchitis is still a prevalent disease. Therefore, due to a large number of outbreaks, mumps orchitis should still be considered, especially in teenagers and during autumn season. Conduct of additional long-term follow-up and large prospective studies is needed in Korea.
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Genitourinary Tuberculosis with the Other Extrapulmonary Tuberculosis
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Byeong Kuk Ham, Tae Il Noh, Jong Hyun Pyun, Su Hwan Shin, Ji Sung Shim, Jae Hyun Bae
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Korean J Urogenit Tract Infect Inflamm 2012;7(2):182-186. Published online October 31, 2012
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- When the infection occurs in other parts of the body it is called extrapulmonary tuberculosis. About 15% of tuberculosis cases are extrapulmonary. Tuberculous lymphadenitis is the most commonly occurring form of extrapulmonary tuberculosis, and skeletal tuberculosis most often involves the spine, followed by tuberculous arthritis in weight-bearing joints and extraspinal tuberculous osteomyelitis. Genitourinary tuberculosis contributes to 10-20% of extrapulmonary tuberculosis. A 59 year old woman was admitted with lower back pain and lower urinary tract symptoms. A CT scan showed focal enhancing wall thickening in the left proximal ureter with left hydronephrosis and multiple enlarged lymph nodes. The Radiologic and pathologic diagnosis revealed genitourinary tuberculosis with the other extrapulmonary tuberculosis. (Korean J UTII 2012;7:182-186)
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Characteristics of Recent 10 Cases of Fournier's Gangrene
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Myeong Heon Jin, Mi Mi Oh, Jae Hyun Bae, Hong Soek Park, Duck Ki Yoon, Du Geon Moon
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Korean J Urogenit Tract Infect Inflamm 2007;2(2):203-208. Published online October 31, 2007
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- "Purpose: Fournier’s gangrene is a rare and potentially fatal infectious disease characterized by necrotic fasciitis of the perineum and abdominal wall, along with the scrotum and penis in men and the vulva in women. The aim of this study is to share our recent experience with the management of this difficult infectious disease. Materials and Methods: The authors reviewed retrospectively the clinical records of a series of 10 patients with Fournier’s gangrene between the years 2004 and 2007 who, after initial treatment. The patient’s age, predisposing etiological factors, interval between onset of symptoms and diagnosis, lesion site, results of bacteriologic cultures, treatment and reconstructive procedures, length of hospital stay, treatment and outcome were analyzed. Results: The patients' ages ranged between 46 and 84 years (mean 59 years). Of the 10 patients, 1 (10%) died and 9 (90%) survived. The predisposing factors included diabetes mellitus (10 cases, 100%), hypertention (3 cases, 30%), liver cirrhosis (2 cases, 20%), CVA (1 case, 10%). All 10 patients had positive culture results, with 9 (90%) of these being polymicrobial. The most common organisms isolated were Escherichia coli (n=6), Staphylococcus aureus (n=4) and Streptococcus agalactiae (n=2). The important finding wass the fact that quinolone-resistant extended spectrum beta-lactamase (ESBL) Escherichia coli (E. coli) was detected in two cases (20%). The mean length of hospital stay was 41.1 days (7-70). Conclusions: There is no differences between current study and previous, butit is important that ESBL producing E. coli was appeared. It may have influence on length of hospital stay and wound healing. However, more studies are required to conclusively prove the effect of ESBL on prognosis of Fournier’s gangrene."
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