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Review
. 2021 Jan 21:7:609024.
doi: 10.3389/fmed.2020.609024. eCollection 2020.

Encrusted Uropathy: A Comprehensive Overview-To the Bottom of the Crust

Els Van de Perre  1 , Gina Reichman  2 , Deborah De Geyter  3 , Caroline Geers  4 , Karl M Wissing  1 , Emmanuel Letavernier  5   6
Affiliations
Review

Encrusted Uropathy: A Comprehensive Overview-To the Bottom of the Crust

Els Van de Perre et al. Front Med (Lausanne). .

Abstract

Encrusted uropathy is a rare subacute to chronic inflammatory disorder caused by infection with urease-producing bacteria, mainly Corynebacterium urealyticum. The disorder is characterized by urothelial deposition of struvite and carbonated apatite, resulting in encrustations and ulceronecrotic inflammation of the urothelium and surrounding tissues. Most commonly, encrusted uropathy is encountered in patients with predisposing conditions. The disease remains underdiagnosed. High urinary pH and negative conventional urine cultures should raise suspicion of the diagnosis. Prognosis is dependent on timely diagnosis and treatment installment, which consists of urological removal of encrustations in combination with urinary acidification and long-term antibiotic therapy.

Keywords: Corynebacterium urealyticum; encrusted cystitis; encrusted pyelitis; encrusted uropathy; urease-producing bacteria.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Urease as the main cause of struvite formation.
Figure 2
Figure 2
Diagnosis of encrusted uropathy.
Figure 3
Figure 3
Non-enhanced CT-scan showing encrusted pyelitis. White arrow: linear calcifications of the renal collecting system with bilateral ureterohydronephrosis, black arrow: nephrostomy catheter.
Figure 4
Figure 4
Haematoxylin and eosin staining of the pyelic mucosa in a patient with encrusted pyelitis showing a broad ulceration covered by a layer of fibrin (black arrow) and calcified necrotic debris (white arrows).
Figure 5
Figure 5
Haematoxylin and eosin staining of the renal parenchymal lesions in a patient with encrusted pyelitis showing severe chronic changes due to chronic pyelonephritis (black arrows).
See this image and copyright information in PMC

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