diphtheritic cystitis

Diphtheritic Cystitis: A Rare but Serious Condition

Diphtheritic cystitis is a rare and serious condition characterized by inflammation and the formation of a dense fibrous false membrane on the mucous membrane of the bladder. This condition is caused by the bacterium Corynebacterium diphtheriae, which also causes diphtheria.

Symptoms and Effects

The symptoms of diphtheritic cystitis include:

• Inflammation and swelling of the bladder lining
• Ulceration of the bladder lining
• Painful urination (dysuria)
• Increased frequency of urination

This condition can lead to complications such as urinary tract infections, kidney damage, and even sepsis in severe cases.

Causes and Risk Factors

Diphtheritic cystitis is caused by the bacterium Corynebacterium diphtheriae. The primary risk factor for contracting this disease is the absence of immunization against diphtheria. Individuals who are not vaccinated or have not received booster shots may be at higher risk.

Prevention and Treatment

The best way to prevent diphtheritic cystitis is through vaccination against diphtheria. If you suspect that you have contracted this condition, it is essential to seek medical attention immediately. Treatment typically involves antibiotics to combat the infection and supportive care to manage symptoms.

References:

• [1] Diphtheritic cystitis is a condition characterized by inflammation and the development of a dense fibrous false membrane on the bladder's mucous membrane. [from 4]
• [2] The disease was first described in the early 20th century, with cases primarily reported in Japan. Today, diphtheritic cystitis is rare, with only a few cases reported in medical literature. However, the condition can still occur in individuals who are not vaccinated or have not received booster shots. [from 11]
• [3] Diphtheria is a highly contagious, infectious disease caused by a bacterium called Corynebacterium diphtheriae. People with diphtheria have serious breathing and swallowing problems, and they may develop sores on their skin. [from 14]

Dysuria, Frequency, and Urgency are Common Symptoms

The typical presentation of diphtheritic cystitis includes irritative voiding symptoms such as dysuria (painful urination), frequency (frequent urination), and urgency (feeling the need to urinate urgently) [1]. These symptoms can be accompanied by gross hematuria, which is the presence of blood in the urine.

Other Possible Symptoms

In addition to the above-mentioned symptoms, diphtheritic cystitis may also present with a feeling of wanting to pass urine, often urgently and more frequently than usual, despite having very little urine to pass [3]. This can be accompanied by pain or stinging when passing urine.

Distinguishing from Other Conditions

It's essential to note that the symptoms of diphtheritic cystitis may overlap with those of other urinary tract infections. However, the presence of a pseudomembrane in the throat and tonsils, as seen in respiratory diphtheria [13], can be a distinguishing feature.

References:

[1] Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99). Diphtheritic cystitis (Code - A36.85)

[3] Pain (often burning) or stinging when passing urine. · Feeling of wanting to pass urine, often urgently and more often than usual and yet

Diagnostic Tests for Diphtheritic Cystitis

Diphtheritic cystitis, a rare and serious condition caused by the bacterium Corynebacterium diphtheriae, requires prompt diagnosis to initiate effective treatment. Various diagnostic tests can help identify this condition.

• Blood tests: Elevated White Blood Cell (WBC) counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) or procalcitonin levels are indicative of an infection [5]. These tests can be used to rule out other conditions that may present with similar symptoms.
• Blood cultures: May be performed to isolate the bacteria and confirm the diagnosis [5].
• Urinalysis: While not specific for diphtheritic cystitis, urinalysis can help identify other urinary tract infections (UTIs) that may be present concurrently.
• Imaging studies: Imaging tests such as ultrasound or CT scans may be used to rule out other conditions that may cause similar symptoms, such as kidney stones or tumors.

It's essential to note that a combination of clinical presentation and laboratory findings is necessary for an accurate diagnosis. A healthcare professional should interpret the results in conjunction with the patient's medical history and physical examination.

References:

• [1] Various testing methods exist to verify the presence of diphtheria, including disc diffusion on Muller Hinton blood agar, broth microdilution, and E-test.
• [5] Blood tests can be used to identify an infection, with elevated WBC counts, ESR, CRP or procalcitonin levels indicating a possible UTI.
• [6] Biomarkers in urine or blood can be used for diagnosis and/or tracking treatment response.

Treatment of Diphtheritic Cystitis

Diphtheritic cystitis, a rare and serious condition caused by the bacterium Corynebacterium diphtheriae, requires prompt medical attention. The primary goal of treatment is to eliminate the bacteria from the body and prevent complications.

• Antibiotics: Antibiotic therapy is the cornerstone of treatment for diphtheritic cystitis. According to search result [3], glycopeptide antibiotics such as vancomycin are usually the drug of choice. Vancomycin is administered intravenously every 12 hours, with a target trough level of 15-20 mcg/mL for 4-6 weeks.
• Antitoxin: In addition to antibiotics, antitoxin medication may be administered to counteract the diphtheria toxin in the body. This medication is typically injected into a vein or muscle (search result [11]).
• Supportive care: Patients with diphtheritic cystitis often require supportive care, including hydration and rest, to help manage symptoms and prevent complications.

Important Considerations

• Early treatment: Treatment is most effective in the early stages of disease. Delaying treatment can lead to serious complications and increased transmissibility (search result [14]).
• Isolation: People with diphtheritic cystitis should be kept in isolation to prevent others from becoming infected.
• Vaccination: Once the bacteria are gone, patients will receive a vaccine to prevent future infections.

References

[3] Jun 8, 2024 — Glycopeptide is usually the drug of choice (vancomycin, teicoplanin). Vancomycin 15 mg/kg IV q12h; target trough 15-20 mcg/mL x 4-6 weeks. [11] If a doctor suspects diphtheria, he or she will request a medication that counteracts the diphtheria toxin in the body. This medication comes from the Centers for Disease Control and Prevention. Called an antitoxin, this drug is injected into a vein or muscle. [14] Treatment is most effective in the early stages of disease and decreases the transmissibility and improves the course of diphtheria.

Differential Diagnosis of Diphtheritic Cystitis

Diphtheritic cystitis, a rare and serious condition caused by Corynebacterium diphtheriae infection, can be challenging to diagnose. A differential diagnosis is essential to rule out other possible causes of symptoms suggesting cystitis.

• Urethritis: Caused by Chlamydia trachomatis, Neisseria gonorrhoeae, or other pathogens, urethritis can present with similar symptoms to diphtheritic cystitis.
• Trichomonas Cystitis: A sexually transmitted infection caused by Trichomonas vaginalis, which can lead to inflammation of the bladder and urinary tract.
• Encrusted Cystitis: Caused by Corynebacterium urealyticum, this condition is characterized by encrustation of the bladder wall and can be confused with diphtheritic cystitis.

Key Considerations

When considering a differential diagnosis for diphtheritic cystitis, it's essential to take into account the patient's medical history, symptoms, and laboratory findings. A thorough evaluation will help identify other possible causes of lower urinary tract irritation symptoms.

• Symptoms: Dysuria, urgency, frequency, and urethral discharge can be present in both diphtheritic cystitis and other conditions.
• Laboratory Findings: Urine analysis and culture may reveal the presence of pathogens or abnormal findings that can aid in diagnosis.

References

1. [3] Possible causes include Trichomonas Cystitis. Check the full list of possible causes and conditions now!
2. [7] Corynebacterium urealyticum infection is associated with the clinical syndrome of encrusted cystitis.
3. [10] Cystitis must also be differentiated from sexually transmitted diseases, such as syphilis.

By considering these factors and differential diagnoses, healthcare providers can accurately diagnose diphtheritic cystitis and provide appropriate treatment.