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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 57-year-old woman, known to have diabetes mellitus, presented with a one-week history of fever, dysuria, and left flank pain. Computed tomography showed extensive left renal parenchymal destruction and a large gas collection. Urine culture revealed growth of Escherichia coli. The diagnosis of emphysematous pyelonephritis was confirmed at left nephrectomy. The clinical manifestations of emphysematous pyelonephritis, types of gas-forming renal infection, and their radiological findings are discussed.
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PMID:Clinics in diagnostic imaging (99). Left emphysematous pyelonephritis. 1522 Oct 52

A case of retroperitoneal abscess with an unknown origin is presented. A 60-year-old woman visited our hospital complaining of fever and right flank pain. Abdominal computed tomography and ultrasound examination revealed retroperitoneal abscess posterior to right kidney. Percutaneous drainage and administration of antibiotics were performed. Then, both symptoms were improved. The fluid culture proved to be anaerobic bacteria, Peptostreptococcus species and Porphyromonas asaccharolytica. She had no history of surgery or diabetes mellitus. The origin of this abscess was unknown.
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PMID:[A case of retroperitoneal abscess by anaerobic bacteria]. 1557 25

A gastrointestinal stromal tumor of the stomach mimicking an adrenal tumor in a 67-year-old woman is reported. The patient sought medical attention for left flank pain in December 2001. A spherical calcification was evident in the left hypochondrium in an abdominal radiography, and computed tomography revealed a mass 8 cm in diameter at the upper pole of the left kidney. She then was admitted to our hospital. Physical examination and laboratory screening showed hypertension, diabetes mellitus and slight hemoconcentration. Endocrine examination showed normal serum adrenal hormone concentrations. Magnetic resonance imaging again demonstrated the mass, which showed enhancement along its margins after intravenous contrast administration. With a preoperative diagnosis of adrenal tumor, we performed total resection. The pediculated tumor, arising from the stomach, showed c-kit immunohistochemical staining permitting a histopathological diagnosis of gastrointestinal stromal tumor.
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PMID:[Gastrointestinal stromal tumor of the stomach mimicking adrenal tumor: a case report]. 1568 56

Bilateral emphysematous pyelonephritis is a rare life-threatening condition affecting almost exclusively patients with diabetes mellitus. Symptoms, which include fever, chills, abdominal and flank pain, nausea, vomiting, dysuria and pyuria, usually mimic those of classic pyelonephritis, and thus clinical suspicion for this urgent condition should be raised in every diabetic patient with similar presentation. Computed tomography (CT) remains the gold standard for the diagnosis demonstrating gas in the renal parenchyma, collecting system or perinephric tissue. Treatment, which should be aggressive, is classically surgical, and early nephrectomy is recommended. Percutaneous drainage associated with medical treatment might be an alternative. Successful exclusively medical treatment has been described but is infrequent and is reserved as an alternative for patients in whom surgical intervention is contraindicated. We report a case of bilateral emphysematous pyelonephritis in an 82-year-old female diabetic patient who presented with symptoms of typical pyelonephritis. Diagnosis was confirmed by CT, and Escherichia coli was identified as the causative factor. The patient was successfully treated medically with intravenous administration of cefepime and amikacin for 14 days and recovered fully. The therapeutical options for this severe but rare condition are discussed.
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PMID:Nonsurgical treatment of bilateral emphysematous pyelonephritis in a diabetic patient. 1713 98

Pheochromocytomas are rare catecholamine-secreting, chromaffin tumors of the autonomic nervous system. Most pheochromocytomas are sporadic, but up to 24% of pheochromocytomas are part of a familial disorder. Here we describe a female patient, who presented to our outpatient clinic 18 years after removal of a pheochromocytoma of the left adrenal gland in China. Now she reported flank pain on the left side and elevated blood pressure. 24-hour urinary catecholamines, metanephrines, and normetanephrines as well as plasma-norepinephrine were elevated. The transabdominal ultrasonography revealed a tumor with reduced echogenicity in the left suprarenal region, which was suspected to be a recurrent pheochromocytoma. This finding was confirmed by MRT and J (123)-MIBG-scan. Parathyroid hormone (PTH) and calcitonin were in the normal range. After surgical excision, histological examination of the adrenal mass proved to be a pheochromocytoma. Molecular genetic analysis with sequencing of the succinate dehydrogenase type B (SDHB) gene revealed a formerly unknown mutation of codon 214 (CAG-->TAG) leading to an amino acid change of glutamine to a stop-Codon (Q214X-mutation) in exon 6. This case report highlights the necessity of re-evaluating patients with nonsyndromic pheochromocytoma who are diagnosed without genetic testing to estimate the risk of a relapse and to initiate testing of first-degree relatives.
Exp Clin Endocrinol Diabetes 2007 Oct
PMID:Relapsing pheochromocytoma in a Chinese women caused by a novel mutation in exon 6 of the SDHB gene: a case report. 1794 98

A 56-year-old woman with obesity and poorly controlled diabetes mellitus presented with a two-day history of abdominal fullness and vomiting. No fever, flank pain or dysuria was present. On admission, her blood urea nitrogen concentration was 74 mg per deciliter and the serum creatinine concentration was 3.5 mg per deciliter. Laboratory data revealed an elevated white blood cell count (11.72 x 10(3)/ml), blood sugar (826 mg/dl), pyuria (WBC 30-50/HPF) and negative urine ketone. A plain abdominal radiograph revealed right renal stones and localized air accumulation at the left upper abdominal area.
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PMID:Emphysematous pyelonephritis with acute renal failure. 1861 55

Emphysematous or gas-forming infections, a very small percentage of bacterial infections of the urinary tract, attract importance because of their life threatening potential. Herein, we report a 60-year-old Saudi female patient who was a known case of Diabetes mellitus for 15 years. She was admitted with left flank pain of 5 days duration, abdominal distension, nausea, vomiting and chills associated with increased frequency of urine, urgency, and dysuria. She had leukocytosis, high blood sugar, elevated urea and creatinine and pyuria. Urine culture grew Escherichia coli. Ultrasound and CT scan showed left pelvicalyceal dilatation and air in the left kidney and urinary bladder. She was treated with a prolonged parenteral antibiotic course, and insulin, with complete recovery.
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PMID:Gas-forming urinary tract infection. 1894 Jan 28

We report a 50-year-old man with poorly controlled diabetes mellitus who presented with a painful, swollen right leg. He had also experienced right flank pain for 1 week prior to admission. Physical examination was notable for tenderness over the right flank. The right leg was diffusely swollen and exquisitely tender to touch, with palpable crepitance. Laboratory tests revealed leukocytosis and pyuria. Computed tomography showed a right ureteral stone with hydronephrosis and characteristic findings of emphysematous pyelonephritis. Furthermore, a right perirenal gas-forming abscess with extension to the right leg was noted. The patient was successfully treated with antibiotic therapy, aggressive control of blood sugar, percutaneous drainage of the hydronephrosis and perirenal abscess, and aggressive debridement of the leg.
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PMID:Emphysematous pyelonephritis presenting as necrotizing fasciitis of the leg. 1929 26

A 96-year-old female visited our hospital with a complaint of right flank pain. She was under treatment for diabetes mellitus, hypertension and moderate renal dysfunction in the department of internal medicine. Computer tomographic (CT) scan showed a mass 12 cm in diameter compressing the right kidney and inferior vena cava. We diagnosed the right renal cyst. Eight weeks later, CT scan revealed a gradual increase of the mass. We punctured the tumor in order to reduce her complaint and investigate the rumor. Because contrast material could not be infused into the mass, needle biopsy was performed. Pathological examination revealed hypercellularity of spindle cells, that showed positive for CD34, vimentin, desmin and Mic-2, and negative for S100, alphaSMA, c-kit, AE1/3, p53 and bcl-2. The tumor was finally diagnosed as solitary fibrous tumor.
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PMID:[A case of retroperitoneal solitary fibrous tumor]. 2061 Sep 22

A 70-year-old man with a medical history of diabetes mellitus presented to a local clinic with seven days history of right flank pain and fever. Because there was no symptomatic improvement after one-week antibiotic administration, abdominal ultrasonography and computed tomographic scans were performed to show mass lesions in the right hydropelvis, and he was transferred to our hospital. Retrograde pyelography revealed a retrocaval ureter and a ureteral stent was indwelt. After the symptoms improved, the lesions were removed by percutaneous nephrostomy and fungal balls were diagnosed as Candida parapsilosis after culture. After intermittent one-week irrigation of the renal pelvis with normal saline, the nephrostomy tube was removed. In six-month follow-up, mild hydronephrosis remains without fungal ball recurrence. To the best our knowledge, there has been no case report of Candida parapsilosis fungal balls in the urinary tract.
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PMID:[A case of Candida parapsilosis fungal balls in the urinary tract associated with a retrocaval ureter]. 2080 63


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