Penicillin G-induced Hemorrhagic Cystitis with Hydronephrosis

Yuichiro Toma; Tetsuya Ishiki; Kazufumi Nagahama; Koichiro Okumura; Tomomasa Kamiyama; Kentaro Kohagura; Ayano Kakihana; Takeshi Tana; Yusuke Ohya; Shuichi Takishita

doi:10.2169/internalmedicine.48.1842

CASE REPORTS

Penicillin G-induced Hemorrhagic Cystitis with Hydronephrosis

Yuichiro Toma, Tetsuya Ishiki, Kazufumi Nagahama, Koichiro Okumura, Tomomasa Kamiyama, Kentaro Kohagura, Ayano Kakihana, Takeshi Tana, Yusuke Ohya, Shuichi Takishita

Author information

Yuichiro Toma
The Third Department of Internal Medicine, University of the Ryukyus
Tetsuya Ishiki
The Third Department of Internal Medicine, University of the Ryukyus
Kazufumi Nagahama
The Third Department of Internal Medicine, University of the Ryukyus
Koichiro Okumura
The Third Department of Internal Medicine, University of the Ryukyus
Tomomasa Kamiyama
The Third Department of Internal Medicine, University of the Ryukyus
Kentaro Kohagura
The Third Department of Internal Medicine, University of the Ryukyus
Ayano Kakihana
Shuri Jokamachi Medical Clinic
Takeshi Tana
Shuri Jokamachi Medical Clinic
Yusuke Ohya
The Third Department of Internal Medicine, University of the Ryukyus
Shuichi Takishita
The Third Department of Internal Medicine, University of the Ryukyus

Keywords: penicillin G, hemorrhagic cystitis, interstitial nehritis, infectious endocarditis

JOURNAL OPEN ACCESS

2009 Volume 48 Issue 18 Pages 1667-1669

DOI https://doi.org/10.2169/internalmedicine.48.1842

Details

Abstract

Irritable urological symptoms with gross hematuria and bilateral lumbar pain developed when the patient received penicillin G for endocarditis. These symptoms were followed by renal insufficiency. A contrast-enhanced abdominal computed tomography (CT) scan revealed a thickened bladder wall, bilateral hydroureter and hydronephrosis, suggesting hemorrhagic cystitis complicated with urinary tract obstruction. Urine culture was negative. After discontinuation of penicillin G, all symptoms subsided and renal function recovered; hence, penicillin G seems to have been associated with hemorrhagic cystitis and acute kidney injury. Positive findings in the drug lymphocyte stimulation test (DLST) for penicillin G were consistent with this diagnosis.

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