Chronic Colovesical Fistula Leading to Chronic Urinary Tract Infection Resulting in End-Stage Renal Disease in a Chronic Granulomatous Disease Patient

M R Siddiqui; T Sanford; A Nair; C S Zerbe; M S Hughes; L Folio; Piyush K Agarwal; S J Brancato

doi:10.1016/j.eucr.2016.12.002

Chronic Colovesical Fistula Leading to Chronic Urinary Tract Infection Resulting in End-Stage Renal Disease in a Chronic Granulomatous Disease Patient

Urol Case Rep. 2017 Jan 10:11:37-38. doi: 10.1016/j.eucr.2016.12.002. eCollection 2017 Feb.

Authors

M R Siddiqui¹, T Sanford¹, A Nair¹, C S Zerbe², M S Hughes³, L Folio⁴, Piyush K Agarwal¹, S J Brancato⁵

Affiliations

¹ Urologic Oncology Branch, National Cancer Institute, NIH, USA.
² Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Disease, NIH, USA.
³ Surgical Oncology Branch, National Cancer Institute, NIH, USA.
⁴ Radiology and Imaging and Sciences, Clinical Center, National Institutes of Health, USA.
⁵ University of Iowa, USA.

Abstract

A 46-year old man with X-linked chronic granulomatous disease (CGD) being followed at the National Institute of Health with uncontrolled CGD colitis who developed chronic colovesical fistula, and end-stage renal disease (ESRD). Despite aggressive medical management of symptoms with immunomodulators and antibiotic prophylaxis, the chronic colovesical fistula led to chronic pyelonephritis, recurrent urinary tract infections, persistent air in the collecting system and bladder, and post-renal obstruction resulting in renal failure. Patient is now hemodialysis dependent and required diverting loop ileostomy placement. This report highlights multiple potential etiologies of rising serum creatinine in patients with CGD.

Keywords: Chronic granulomatous disease; Colitis; Colovesical fistula; Post-renal obstruction; Pyelonephritis; Urinary tract infections.

Publication types

Case Reports