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- W4378976304 abstract "Abstract Background It is rare for calcium oxalate renal stone, presented mainly in clean and sterile urine, to result in urinary tract infection. Nevertheless, the stone-related infection could further develop thoracic spondylodiscitis and epidural abscesses, causing neurological deficits, including muscle weakness and paresthesia. Although few cases of urinary tract infection and spondylodiscitis were reported, there are no reports about calcium oxalate partial staghorn stone and spondylodiscitis in the literature. Case presentation: A 62-year-old male suffered from gross hematuria, intermittent fever, and left flank pain. He came to the urology outpatient department, where acute pyelonephritis was diagnosed, and a left partial staghorn renal stone was seen on CT. Oral antibiotics were prescribed with improvement, and surgical intervention was suggested. Two weeks after antibiotics treatment, he developed acute onset bilateral lower limb weakness and numbness under the nipple level. He was brought to the emergency department, where leukocytosis and pyuria were shown, and the spine MRI revealed T2-T3 spondylodiscitis with epidural abscess and spinal cord compression. He underwent T2-T3 laminoplasty/pediculectomy/facetectomy and discectomy, with improvement in muscle power and hypesthesia. The culture of the surgical lesion yielded Citrobacter koseri , the same as the urine culture obtained at his first visit. Left-side percutaneous nephrolithotomy (PCNL) was performed one month after cefmetazole administration, with successful stone removal and resolution of pyuria. Stone analyses reported the composition of calcium oxalate. Follow-up MRI showed marked improvement with resolution of spinal stenosis and epidural abscess. The patient was discharged, and follow-up urine analyses showed negative pyuria. Conclusions Urinary tract infection resulting from partial staghorn stone, with additional hematogenous spread to CNS causing spondylodiscitis, is scarcely discussed. The case we illustrated was that a calcium oxalate stone, which belongs to Jensen’s classification type 1, should be present in clean and sterile urine. However, a urinary tract infection could be seen in urine stasis or urinary tract obstruction. Citrobacter koseri -related UTI and spondylodiscitis have been described, with few case reports. With accurate diagnosis and essential surgical interventions, the patient had immediate neurological improvement and reached disease-free status." @default.
- W4378976304 created "2023-06-02" @default.
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- W4378976304 date "2023-06-01" @default.
- W4378976304 modified "2023-09-23" @default.
- W4378976304 title "Infected Calcium Oxalate Stone Leading to Pyogenic Spondylodiscitis and Bilateral Lower Limb Weakness: A Case Report" @default.
- W4378976304 doi "https://doi.org/10.21203/rs.3.rs-2943134/v1" @default.
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