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Persistent urinary tract infection despite targeted antibiotics: the role of surgical intervention in encrusted cystitis caused by Corynebacterium urealyticum

Year: 2025

Type: article

Abstract: Background: is a Gram positive, slow-growing bacterium that is a most commonly cause of encrusted cystitis. A major clinical problem is recurrent urinary tract infections with encrustation of the bladder mucosa especially for multimorbid individuals with weakened immune systems. Case report: , which was susceptible to vancomycin. The patient received a 7-day course of vancomycin; however, no clinical improvement was observed.Surgical debridement of the urethral and bladder mucosa was subsequently performed, followed by a 2-week course of vancomycin. The patient's clinical condition improved markedly after this combined approach. Conclusion: This case highlights the importance of considering rare infectious agents in patients with recurrent urinary tract infections, particularly in those with a history of multiple hospitalizations and broad-spectrum antibiotic exposure. Infectious calculi can act as a persistent source of infection and may not respond to systemic antibiotic therapy alone. In such cases, surgical debridement of the mucosa is essential to achieve effective treatment. LEARNING POINTS: , especially if they have had previous urological procedures, chronic catheterization or persistent bladder inflammation.Mucosal encrustation and infectious calculi function as chronic foci of infection, reducing the effectiveness of systemic antibiotic therapy alone and contributing to persistent or relapsing symptoms.A multimodal approach, including accurate microbiological identification, targeted antimicrobial therapy and endoscopic removal of encrustations and calculi, is needed to organize the best management of encrusted cystitis.

Source: European Journal of Case Reports in Internal Medicine

DOI: 10.12890/2025_005902

Authors: Beata Krasovska, Ksenija Staravoitova, Viktorija Loginova, Kļims Ļeoņenko

Institutions: Riga Stradiņš University, Pauls Stradiņš Clinical University Hospital

Language: English

Topic: Urinary Tract Infections Management

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $323