Urogenital Tract Infection

Management Strategies and Clinical Guidelines on Pediatric UTI: Kwan Hyun Park; Korean J Urogenit Tract Infect Inflamm 2007;2(1):23-32. Published online May 31, 2007

Abstract PDF: "Urinary tract infection (UTI) in children is a common cause of fever and may be the most common cause of renal parenchymal loss. Clinical and experimental studies have provided that significant renal parenchymal damage can occur after a single UTI. Also, underlying obstructive or refluxing abnormalities in the urinary tract are common in children with UTI. For this reason, the management of UTIs in children is based upon early diagnosis, and minimization of renal damage from acute infection and of further risk of renal parenchymal loss. In this article, specific points in the diagosis and management of the UTIs in children were reviewed. Especially, index of suspicion is the beginning for diagnosis of UTIs in children because all of the symptoms or signs, which suggest UTI, are very nonspecific. Epidemiological background, natural course, and bacteriological basis in the pediatricUTI were also reviewed. In terms of imaging studies, specific imaging techniques are evolving. Thus, the clinicians should be careful in selecting the studies most efficiently and rationally. As clinical guidelines, a suggested algorithm from the AAP (American Academy of Pediatrics) in the diagnosis, treatment, and evaluation of the initial UTI in febrile children is introduced lastly."

6 View
0 Download

HIV/ADIS and Sexually Transmitted Diseases: Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2007;2(1):33-39. Published online May 31, 2007

Abstract PDF: The number of people living with HIV/AIDS continued to grow, estimated to be 39.5 million as of the end of 2006, while 4.3 million people were newly infected in 2006. High risk behaviors (intravenous drug use and unprotected sex bewteen men or with paid sex workers) are the predominent route of transmission. The close relationship between HIV/AIDS and sexually transmitted diseases (STDs) have been well known. Earlier diagnosis and treatment of STDs can be an effective tool in preventing the spread of HIV/AIDS. An understanding of the relationship between STDs and HIV/AIDS can help in the development of effective HIV/AIDS prevention programs for persons with high-risk sexual behaviors. We need to keep in mind that HIV/AIDS is expected to continued to grow in the foreseeable future in Korea as well as globally unless drastic efforts are made to prevent or manage STD adequately and to spread an understanding of the relationship between STDs and HIV/AIDS.

5 View
0 Download

Quinolone Resistance in Urologic Field: Present and Future: Chul Sung Kim; Korean J Urogenit Tract Infect Inflamm 2007;2(1):40-47. Published online May 31, 2007

Abstract PDF: Quinolone has been widely used in urology because urinary tract infection is usually caused by Gram negative pathogens. However, quinolone resistance is increasing due to the increased use of quinolones. Typical quinolone resistance occurs as a result of mutations in the target enzymes and of changes in quinolone entry and efflux pump. Recently, plasmid mediated quinolone resistance has emerged and spread worldwide. The qnr gene of the plasmid produces the Qnr protein, which prevents quinolones from inhibiting the target enzymes. The qnr-bearing strains generate quinolone resistant mutants much more frequently than qnr-free strains. Moreover, The qnr-plasmids carry multiple resistance determinants providing resistance to other antibiotics. Thus, careful attention should be paid to the understanding and prevention of quinolone resistance.

6 View
0 Download

Uropathogenic Escherichia coli Infection and Host Response: Gilho Lee; Korean J Urogenit Tract Infect Inflamm 2007;2(1):48-52. Published online May 31, 2007

Abstract PDF: Urinary tract infections are a result of interactions between the uropathogen and the host. Successful infection of the urinary tract is determined in part by the virulence factors of the bacteria such as type 1 fimbriae and/or P fimbriae, the inoculum size, and the inadequacy of host defense mechanisms. Detection of microorganisms through microbe-associated molecular patterns by Toll-like receptors is crucial to trigger protective innate immunity. A rapid cytokine response was observed when Escherichia coli bacteria infected the epithelial cells with production of interleukin-1ß (IL-1ß), IL-6, and IL-8. These factors play a role in determining the damage to the urinary tract.

9 View
0 Download

Multicenter Clinical Outcome of Gatifloxacin for Chronic Prostatitis (NIH Category II or IIIa) in Korea: Sang Don Lee, Seung Ju Lee, Tae Kon Hwang, Duck Ki Yoon, Kyu Sung Lee, Luck Hee Sung, Myung Soo Choo, Bong Suk Shim, In Rae Cho, Min Eui Kim, Soo Bang Ryu, Chul Sung Kim, Young Gon Kim, Chun Il Kim, Hyun Yul Rhew, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2007;2(1):53-60. Published online May 31, 2007

Abstract PDF: "Purpose: The objective of this study was to investigate the efficacy and safety of gatifloxacin for patients with chronic prostatitis (NIH category II or IIIa) in Korean urologic practice. Materials and Methods: A total of 16 outpatient urology clinics at tertiary care medical centers in Korea participated. Gatifloxacin (400 mg/day) treatment (S.D.) of 149 patients (20 patients with category II and 129 patients with category IIIa) with prostatitis (mean age 45.8±13.3 years) was carried out for 41.7 (33.1) days. A 4-glass test according to Meares and Stamey or two glass test was carried out at study entry and one month after the end of treatment. Clinical response, safety and bacteriological response were assessed before treatment (within 48 hours of initiation of the study medication) and at one month after treatment completion. Results: In a otal of 149 patients, the total NIH-CPSI score was significantly reduced from 20.5 to 10.0 (response rate 86.7%; 95% CI 80.2-93.2%) (p<0.05). Sub-scores of pain, urinary symptoms and impact on the quality of life were also significantly reduced from 8.9 to 3.8 (response rate 83.8%; 95% CI 76.8-90.9%), from 4.2 to 2.0 (response rate 73.3%; 95% CI 64.9-81.8%) and from 7.4 to 4.2 (response rate 79.0%; 95% CI 71.3-86.8%), respectively (p<0.05). In terms of the overall clinical efficacy assessment by investigators, out of 149 patients with prostatitis, 71.2% were assessed to be responders. Bacteriological studies in expressed prostatic secretion (EPS) or post prostate massage urine (VB3) at 1 month after treatment completion demonstrated that the overall eradication rates of pathogens was 85% and the pyuria (≥10 WBC/HPF) rates in the NIH category II and IIIa were 35% and 18.6%, respectively (overall rate 20.8%). There were 16.1% of patients that presented with some adverse events considered by investigators to be related to the drug. The majority of adverse events were considered to be of mild (87.5%) or moderate (8.3%) intensity. Conclusions: These results suggest that gatifloxacin in Korean urologic practice is well tolerated and improves the clinical outcomes in the patientswith chronic prostatitis (NIH category II or IIIa)."

8 View
0 Download

Characterization of Uropathogenic Escherichia coli: Koo Han Yoo, Jeong-Je Cho1, Sun-Ju Lee; Korean J Urogenit Tract Infect Inflamm 2007;2(1):61-65. Published online May 31, 2007

Abstract: " Purpose: Infections of the urinary tract are common allover the world and occur in all ages and both sex. The organism most commonly isolated from all types of urinary tract infections is Escherichia coli. Materials and Methods: We analyzed E. coli from a woman with acute cystitis. Among the pathogenic determinants of the uropathogenic E. coli strains, the p-fimbriae have been known to be associated with upper urinary tract infections. Results: Type 1 fimbriae (fimH), P family fimbriae (papA), S family fimbriae (sfa), hemolysin (hylA) and cytotoxic necrotizing factor I (cnfI) contribute to virulence in the urinary tract. So, it is important to characterize E. coli in laboratory study. Conclusions: The authors have used tools to reveal characteristics of E. coli, such as polymerase chain reaction, hemagglutination, hemolysin assay. This study provides how to characterize E. coli strains."

5 View
0 Download

Clinical Aspects and Short-term Results of Bladder Hydrodistention for Interstitial Cystitis in Young Adult Men: Changseung Liu, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2007;2(1):66-72. Published online May 31, 2007

Abstract PDF: "Purpose: Interstitial cystitis (IC) is prevalent in the mid age women, characterized by frequency, urgency, nocturia, suprapubic pain and dysuria. We estimated the clinical aspects and short-term results of hydrodistention for young male IC patients. Materials and Methods: A retrospective chart review was conducted of 8 patients who had treated for interstitial cystitis between March 2002 and June 2006. They were diagnosed with exclusive criteria from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) group. All of them were normal in urine analysis, prostatic secretion and transrectal ultrasonography (TRUS), and were not improved with anti muscarinic agents. We performed urodynamic study (UDS), potassium chloride sensitivity test (PST) and cystoscopy with hydrodistention under spinal anesthesia. Results: Symptom durations were less than 5 years in 4 (50%) patients, between 5-10 years in 2 (25%) and more than 10 years in 2 (25%). PST was positive in 6 (75%) patients. On cystoscopy, glomerulations were noted in all patients and one (12.5%) had the Hunner's ulcer. On bladder mucosal biopsy, there were mast cells in 2 (25%) specimens. All patients had enlarged both the volume of first voiding sensation and the maximal capacity of bladder with statistical significance and improved symptoms at 1 month after hydrodistention. Conclusions: Symptoms of young male IC patients were not different with general IC symptoms. Even though the results show short-term effects, simple bladder hydrodistention would be the effective treatment modality for them."

6 View
0 Download

Affecting Factors on the Treatment of Acute Pyelonephritis: Jae Min Chung, Seong Choi, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2007;2(1):73-77. Published online May 31, 2007

Abstract PDF: "Purpose: We analyzed the clinical aspects of acute pyelonephritis patients who received hospitalization treatment and the factors to effect a therapy session. Materials and Methods: We evaluated 108 patients with acute pyelonephritis who underwent hospitalization treatment between January 2003 and May 2006. The patients were divided into two groups by history taking, radiological and laboratory finding: group A consisted of 60 patients without co-morbid condition and group B consisted of 48 patients with co-morbid conditions. Comparisons of the two groups were made using independent t-tests with hospitalized durations, uropathogen types, clinical improvement durations, laboratory improvement durations and co-morbid conditions. Results: The analysis included 108 patients with a male to female sexual ratio of 1:7.3, a mean age of 51.3±16.8 years and a mean number of hospitalized days of 9.7±9.2 days. The co-morbid conditions were hypertension in 18 patients (16.7%), LUTS in 16 patients (14.8%), and diabetes mellitus in 15 patients (13.9%). The hospitalized durations of two groups were 7.4±3.3 and 10.5±6.2 days in group A and B. The uropathogen types were all E. coli in group A, whereas E. coli, Pseudomonas and Enterococcus were isolated in group B. Clinical and laboratory improvement duration of group A was significantly shorter than group B. The longer hospitalized duration of group B was seen in chronic renal failure and diabetes mellitus patients for 10.4±5.4 and 14.0±4.3 days and the longer laboratory improvement duration of group B was seen in chronic renal failure and diabetes mellitus patients for 5.3±5.2 and 5.9±5.5 days. Conclusions: We concluded that the acute pyelonephritis with co-morbidity conditions need longer hospitalized days than that without co-morbidity conditions. Two variable (diabetes mellitus, chronic renal failure) that predicted a poor response after therapy for acute uncomplicated pyelonephritis. The more variable uropathogen were identified in a urine culture with co-morbidity conditions."

6 View
0 Download

Clinical Characteristics of Eosinophilic Cystitis in Adults: According to the Cystoscopic Findings: Joon Seong Jeon, In Rae Cho; Korean J Urogenit Tract Infect Inflamm 2007;2(1):78-82. Published online May 31, 2007

Abstract PDF: "Purpose: Eosinophilic cystitis is a rare disease, which was reported 15 cases in Korea. We describe our clinical experience with eosinophilic cystitis patients who were confirmed in pathology. Materials and Methods: Six men and two women were diagnosed with eosinophilic cystitis between 2000 and 2006. Mean patient age at presentation was 71 years (range 62 to 82). A retrospective chart review was performed to assess clinical presentations, diagnosis, treatment and outcomes. Results: 6 patients (75%) presented with combination of gross hematuria and irritative bladder symptoms. 1 patient had acute urinary retention and 1 patient was asymptomatic. Allergic diseases (asthma, allergic contact dermatitis) were present in 2 patients. The remaining 6 patients were associated with urologic disorders (BPH, bladder carcinoma, bladder stone, etc). Laboratory data include peripheral eosinophilia in 3 of 7 (43%), hematuria in all 8, pyuria in 4 of 8 (50%), positive urine culture 2 of 8 (25%). Cystoscopy showed erythema in all cases and tumor-like lesions or edema in 6 (85%). Transurethral resection of the bladder lesion was performed in 2 cases. All patients received antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids and experienced the marked improvement during a follow-up duration. Conclusion: Eosinophilic cystitis is more common in male than female. Most common presenting symptoms were hematuria and irritating bladder symptoms. Resection of the bladder lesion with systemic treatment of corticosteroids, NSAIDs and antibiotics showed good results."

7 View
0 Download

Inflammatory Pseudotumor of the Bladder after Total Hip Replacement: Kwang Woo Lee, Hyun Kee Cho, Kong Jo Kim, Jun Mo Kim, Young Ho Kim, Eun Suk Go, Min Eui Kim; Korean J Urogenit Tract Infect Inflamm 2007;2(1):83-87. Published online May 31, 2007

Abstract PDF: Inflammatory pseudotumor of urinary bladder is a rare benign disease that clinically and radiologically simulates a malignant tumor. We report a case of inflammatory pseudotumor in the urinary bladder after total hip replacement.

5 View
0 Download

Testicular Abscess Secondary to Acute Epididymo-orchitis: Jeong Seon Park, Young Beom Jeong, Jong Kwan Park, Hyung Jin Kim, Young Gon Kim, Young Kyung Park; Korean J Urogenit Tract Infect Inflamm 2007;2(1):88-91. Published online May 31, 2007

Abstract PDF: Testicular abscess is very rare and usually resulted from severe epididymo-orchitis. The most common pathogens are Chlamydia trachomatis, Neisseria gonorrhoeae, and Escherichia coli. The inflammation usually starts in male genitourinary tract and spreads to testis. The testis is enlarged, yellow-white and may show abscess formation. The microscopic findings of testicular abscess demonstrated predominent inflammatory cells (neutrophils) in the interstitium and seminiferous tubules. The patient with testicular abscess usually present with fever, dysuria, and a painful scrotal enlargement. Physical examination may not be possible due to pain and swelling, making it difficult to evaluate the real extent of the lesion. In these patients, doppler US findings are useful. We report a case of testicular abscess secondary to acute epididymo-orchitis.

6 View
0 Download

Granulomatous Prostatitis after Intravesical BCG Therapy: Sung Woo Park, Chang Yell Lee, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2007;2(1):92-95. Published online May 31, 2007

Abstract PDF: Granulomatous prostatitis is rarely reported pathologic condition after BCG instillation. But, it's real incidence might be much higher. The incidence, diagnosis, and treatment of these conditions are not confirmed. Herein, the case of granulomatous prostatitis, caused by intravesical BCG instillation is reported.

7 View
0 Download

Renal Tuberculosis Mimicking Abscess in Calyceal Diverticulum: Dong Hoon Lim, Yun Il Kang, Hyung Yoon Moon, Joon Rho, Chul Sung Kim; Korean J Urogenit Tract Infect Inflamm 2007;2(1):96-99. Published online May 31, 2007

Abstract PDF: Renal tuberculosis is a rare disease, which can be easily misdiagnosed. Radiologically the following conditions may mimic renal tuberculosis: chronic pyelonephritis, papillary necrosis, medullary sponge kidney, calyceal diverticulum, renal carcinoma and xanthogranulomatous pyelonephritis. A 27 year old woman presented with recurrent episodes of urinary frequency and intermittent febrile sensation. Laboratory studies for genitourinary tuberculosis showed negative results. Excretory urography and abdominal CT scan revealed the finding of abscess in cealyceal diverticulum in the right kidney. Under the clinical diagnosis of an abscess in calyceal diverticulum, right partial nephrectomy was performed. The pathologic diagnosis revealed renal tuberculosis. We report a case of renal tuberculosis mimicking abscess in calyceal diverticulum.

7 View
0 Download

Penile Abscess due to Condom Catheterization: Kyung Soo Choi, Young Beom Jeong, Jong Kwan Park, Hyung Jin Kim, Young Gon Kim, Young Kyung Park; Korean J Urogenit Tract Infect Inflamm 2007;2(1):100-102. Published online May 31, 2007

Abstract PDF: Penile abscess is very rare. The pathogens are Neisseria gonorrhoeae, Tuberculosis, Staphylococcus aureus, etc. The penis is enlarged, yellow-white and may show abscess formation. The microscopic findings of penile abscess is that neutrophils are the predominant inflammatory cells and are present in the interstitium. The patient with penile abscess may present with fever, dysuria, and a painful penile enlargement. Physical examination may be possible even though there is pain and swelling, not making it difficult to evaluate the real extent of the lesion. To diagnose, doppler US findings are useful. We report a case of penile abscess due to the use of condom catheter.

8 View
0 Download

Previous issues