Primary iliopsoas abscess is a rare but potentially serious condition. The diagnosis is frequently delayed due to its variable and nonspecific features and occult clinical course. The delayed diagnosis and treatment of iliopsoas abscess is the major poor prognostic factor. We report a rare case of primary iliopsoas abscess that presented as a femoral neuropathy in a patient on hemodialysis. A 49-year-old man with end stage renal disease was admitted due to pain in the left inguinal area, and weakness and hypoesthesia of left lower leg. Left iliopsoas abscess was confirmed by CT and MRI. Left femoral neuropathy was diagnosed with electrodiagnostic study. Iliopsoas abscess with femoral neuropathy was completely treated with CT-guided aspiration, antibiotics and prolonged physical therapy of hip and knee joints. To our knowledge, this is the first case report of primary iliopsoas abscess presented as a femoral neuropathy in a patient on hemodialysis in Korea.
Anti-Bacterial Agents ; Delayed Diagnosis ; Diagnosis ; Femoral Neuropathy* ; Hip ; Humans ; Hypesthesia ; Kidney Failure, Chronic ; Knee Joint ; Korea ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Psoas Abscess* ; Renal Dialysis*

Emphysematous cystitis is a rare disease that is associated with diabetes mellitus, neurogenic bladder, chronic genitourinary infection, and malignancy. Fever, chill, abdominal pain, and urinary difficulties were the most frequent presenting symptoms associated with emphysematous cystitis. We report a case of incidentally detected asymptomatic emphysematous cystitis in a 67 years old female patient with diabetic nephropathy. We review characteristic features of all 19 cases that has been reported in korean medical journals till now. Risk factors for this condition appear to be female sex, old age, and diabetes mellitus.
Abdominal Pain ; Aged ; Cystitis* ; Diabetes Mellitus ; Diabetic Nephropathies ; Female ; Fever ; Humans ; Korea* ; Rare Diseases ; Risk Factors ; Urinary Bladder, Neurogenic

Sclerosing peritonitis is a rare but fatal complication of peritoneal dialysis (PD). Management of sclerosing peritonitis includes cessation of PD, total parenteral nutrition, and surgery. Recently, a few reports have indicated immunosuppression might be beneficial in sclerosing peritonitis. In these reports, all of patients had the combination therapy of steroid and immunosuppressant. A 37-year old man develped sclerosing peritonitis 3 months after switching from PD to hemodialysis because of uncontrolled peritonitis. An abdominal computed tomography (CT) scan demonstrated massive ascites with multilocuated fluid collection and extensive enhancement of the peritoneum. A peritoneal biopsy showed proliferation of fibrous collagenous tissue with infiltration of lymphocytes. We started corticosteroid for one month. A follow-up CT scan showed complete resolution with absence of peritoneum thickness and fluid collection 16 months after corticosteroid therapy. The patient currently remains free of symptoms in an outpatient hemodialysis unit. To our knowledge, this is the first case of sclerosing peritonitis successfully treated with corticosteroid therapy alone in Korea.
Adult ; Ascites ; Biopsy ; Collagen ; Follow-Up Studies ; Humans ; Immunosuppression ; Korea ; Lymphocytes ; Outpatients ; Parenteral Nutrition, Total ; Peritoneal Dialysis ; Peritoneum ; Peritonitis* ; Renal Dialysis ; Tomography, X-Ray Computed

No abstract available.

No abstract available.
Nephrogenic Fibrosing Dermopathy

Kidney transplant recipients are more susceptible to rhabdomyolysis because of both the numerous medicines they take, such as immunosuppressants, lipid-lowering agents, and antihypertensive agents, and post-transplantation complications, such as posttransplantation diabetes mellitus and hyperuricemia. Pure hypothyroidism is a rare cause of rhabdomyolysis, and few cases of rhabdomyolysis induced by hypothyroidism have been reported in kidney transplant recipients. We report a case of rhabdomyolysis induced by unrecognized hypothyroidism in a kidney transplant patient, and discuss hypothyroidism and other precipitating factors as a cause of rhabdomyolysis, with a review of the literature.
Antihypertensive Agents ; Diabetes Mellitus ; Humans ; Hyperuricemia ; Hypothyroidism ; Immunosuppressive Agents ; Kidney ; Precipitating Factors ; Rhabdomyolysis ; Transplants

Bacterial peritonitis is a well-recognized complication of continuous ambulatory peritoneal dialysis (CAPD) in patients with end-stage renal failure. Achromobacter xylosoxidans subsp. xylosoxidans is a catalase and oxidase positive, motile, nonfermentative and gram-negative rod bacterium that is a rare pathogen in humans and has rarely been reported as an opportunistic human pathogen. We present a case of peritonitis due to unusual pathogens, Achromobacter xylosoxidans subsp. xylosoxidans. A 49-year-old diabetic man undergoing CAPD for 90 days developed the first peritonitis due to Achromobacter xylosoxidans subsp. xylosoxidans. A. xylosoxidans was detected from a culture of peritoneal fluid. Susceptible antibiotic treatment was provided.
Achromobacter ; Achromobacter denitrificans ; Ascitic Fluid ; Catalase ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Oxidoreductases ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis

Emphysematous pyelonephritis is an unusual, severe gas-forming infection of renal parenchyma and its surrounding areas. It is a rare cause of septic pulmonary embolism. We report on a case of emphysematous pyelonephritis complicated with renal vein thrombosis and septic pulmonary embolism with review of the literature. A 51-year-old diabetic woman was admitted to our hospital with symptoms of fever, diffuse abdominal pain and nausea. Her initial laboratory findings showed pyuria and leukocytosis. She was diagnosed with acute pyelonephritis with abscess formation on contrast enhanced abdominal CT. She was treated with antibiotics and percutaneous abscess aspiration, but progressed to emphysematous pyelonephritis complicated with renal vein thrombosis and septic pulmonary embolism. Finally she underwent the left total nephrectomy.
Abdominal Pain ; Abscess ; Anti-Bacterial Agents ; Female ; Fever ; Humans ; Leukocytosis ; Middle Aged ; Nausea ; Nephrectomy ; Pulmonary Embolism ; Pyelonephritis ; Pyuria ; Renal Veins ; Sepsis ; Thrombosis

Infections are the second leading cause of mortality among patients with end-stage renal disease (ESRD). Recently, colonization or infection with vancomycin-resistant enterococci (VRE) is increasing in prevalence at many institutions and is often reported in dialysis patients. Enterococci are generally considered to be of low pathogenicity but may cause urinary tract infection, bacteremia, endocarditis or meningitis in debilitated patients. Three cases of VRE peritonitis in patients on CAPD were reported, but there was no report of VRE urinary tract infection (UTI) in hemodialysis patients in Korea. We present a case of VRE UTI with pseudomembranous colitis (PMC) in an ESRD patient with anal VRE colonization. The VRE UTI was treated successfully with linezolid.
Acetamides ; Bacteremia ; Coinfection ; Colon ; Dialysis ; Endocarditis ; Enterococcus ; Enterocolitis, Pseudomembranous ; Humans ; Kidney Failure, Chronic ; Korea ; Meningitis ; Oxazolidinones ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Prevalence ; Renal Dialysis ; Urinary Tract ; Urinary Tract Infections ; Vancomycin ; Vancomycin Resistance ; Linezolid

Solid organ transplant recipients are at increased risk for various opportunistic infections because of their immunocompromised state. Pneumocystis jirovecii (carinii) infection has posed serious problems in these patients which can be life threatening. It has been reported that incidences of Pneumocystis infection have dramatically decreased with the use of prophylactic antibiotics. However, there have been reports that say the risks of Pneumocystis infection are increasing with the use of new immunosuppressive drugs and in presence of preceding immunomodulating infections such as CMV infection which is another common opportunistic infection in transplant patients. There were only a few case reports abroad on Pneumocystis infection following CMV infection in patients who underwent kidney transplantation. In Korea, however, there hasnt been any report of such cases. Herein we report a case of a kidney transplant patient who experienced a serious episode of Pneumocystis jirovecii pneumonia following CMV duodenitis. After adequate mechanical ventilation and use of antibiotics the patient completely recovered without any complications.
Anti-Bacterial Agents ; Cytomegalovirus ; Duodenitis ; Humans ; Incidence ; Kidney ; Kidney Transplantation ; Korea ; Opportunistic Infections ; Pneumocystis ; Pneumocystis Infections ; Pneumocystis jirovecii ; Pneumonia ; Respiration, Artificial ; Transplants