PMC8196048_01
Images of CT and urethrography on admission.. Infiltrative shadow in the lower lobe of the right lung was observed (a) (arrow). Bilateral perinephric stranding, thickening of Gerota's fascia, air in the left renal pelvis, and bilateral pelvic distension were observed (b) (arrow). Thickening of the bladder wall, and two areas of high absorption in the anterior urethra were observed on CT, and two foreign bodies in the pendulous urethra were revealed by urethrography (c-f) (arrows).
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Urethrography revealed two foreign bodies in the pendulum urethra that had been inserted during adolescence (Fig. 1).
Longitudinal display of treatment course and inflammatory markers.. WBC, white blood cells; CRP, C-reactive protein; PZFX, pazufloxacin; MEPM, meropenem; MCFC, micafungin; VRCZ, voriconazole; iv., intravenous; po., per oral; *, day of surgical procedure.
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Therefore, intravenous infusion of pazufloxacin (PZFX) (1000 mg, daily) and subcutaneous insulin injection were initiated for the management of emphysematous pyelonephritis and diabetes, respectively (Fig. 2).
Images of chest and abdomen CT on day 12 and foreign bodies after extraction.. Multiple nodular shadows were observed bilaterally in the lungs (a-c). After percutaneous cystostomy, the renal findings remained unchanged, and there was a large amount of urine retention in the bladder (d, e). Urethral foreign body findings: two cylindrical foreign bodies with the appearance of a smoking cessation pipe like plastics were extracted (f).
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Consequently, two cylindrical foreign bodies that resembled smoking cessation pipe-like plastics were removed successfully (Fig. 3).
Time course of chest x-ray imaging.. At the time of admission, there was only an invasive shadow in the lower right lung field (a), but multiple nodules and invasive shadow appeared bilaterally on day 12 (b). With anti-fungal drugs and surgery, these shades gradually improved by day 27 and 36 (c,d).
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After the procedure, the serum beta-D glucan concentration gradually decreased, and improvement was observed in the serum inflammatory markers and abnormal lung shadows (Fig. 4).