Bilateral hydronephrosis due to obstructive ureteral stone associated with norovirus gastroenteritis

Abstract

Recently, cases of urinary tract calculi causing hydronephrosis and postrenal renal failure associated with viral gastroenteritis were documented, yet few were related to norovirus. During norovirus gastroenteritis, observation of oliguria, aciduria, low FENa value, and elevation of blood or urinary uric acid level may necessitate clinical workout for nephrolithiasis.

Keywords: Gastroenteritis; hydronephrosis; norovirus; ureteral calculi; uric acid.

Figure 1

(A) Urine appearance. White and brown fine sandy stones were observed in urine. (B) Ammonium acid urate crystal with haw‐like appearance in the urinary sediment (Sternheimer stain). (C) Sodium urate crystal in the urinary sediment (Sternheimer stain) with spinal‐like appearance (arrows). (D, E) Abdominal ultrasound revealing dilated bilateral pelvises and calculi in the left ureter on admission. Arrows show some fine high echoic lesions in bilateral pelvises. (F, G) Abdominal computed tomography showing dilated calculi in the left ureter on admission. (F) Axial section and (G) coronal section. Arrows indicate urinary stone (4.2 × 8.7 mm) in the left upper ureter.