Urinary tract infection in acute appendicitis.

The effect of acute appendicitis (AA) on aerobic urinary tract infection was investigated. Abnormal urinalysis and urinary tract infection in patients with AA have seldom been reported previously. Appendectomy was performed in 84 patients with no previous urogenital, retroperitoneal, or pelvic disease, trauma or operation and AA was pathologically confirmed in 66 of them. Aerobic cultures of appendiceal tissue and mesenteriolum were done. Control groups included 25 patients with inguinal hernioplasty and 40 patients with varicocele repair. Urinalysis and urine culture were done prior to operation, and on days 1, 3, and 6 postoperatively. The "O" serogrouping identification of Escherichia coli (E. coli) was performed in the appendix, mesenteriolum and urine. Abnormal urinalysis was found in 48% of patients with AA before appendectomy, and in 12% on day 6 postoperatively (P < 0.05). Aerobes were isolated from urine in 32% of patients before appendectomy and in 24% on day 6 following surgery. E. coli was more often found in the appendix than in the mesenteriolum (P < 0.05). In seven out of 66 patients (11%) bacteriuria of more than 10(5) was found. All of them had identical aerobic strain isolated from the appendix, mesenteriolum and urine (E. coli in 4, Streptococcus faecalis in 2 and Corynebacterium species in one patient) according to antimicrobial susceptibility testing and "O" serogrouping of E. coli. Lower urinary tract infection was clinically manifested on day 3 postoperatively in 4 of them and in none from the control groups. Bacteria spreading from the appendix to the retroperitoneal space may invade the urinary tract and cause either symptomatic or asymptomatic urinary tract infection in patients with AA.

Urinalysis, ultrasound analysis, and renal dynamic scintigraphy in acute appendicitis.

OBJECTIVES: The influence of acute appendicitis (AA) on the right kidney and urinalysis was investigated. Permanent damage of the urinary tract and abnormal urinalysis have been previously reported in AA. METHODS: Appendectomy was performed in 84 patients with no previous urogenital, retroperitoneal, or pelvic disease, trauma, or operation. AA was confirmed in 66 of them. Control groups were the remaining 18 patients and 40 patients with varicocele repair. Renal sonography and urinalyses were done prior to operation, on days 1, 3, and 6 postoperatively. Pentetic acid renal scintigraphy was done on postoperative day 1 in patients with abnormal urinalysis. An obstructive radiographic curve indicated furosemide renography. RESULTS: Abnormal urinalysis was found in 48% of patients with AA before appendectomy and in 12% on day 6 postoperatively. Sonography showed pyelocaliceal dilation of the right kidney in 38% of patients with AA prior to appendectomy and in none on day 6 postoperatively. Patients with AA had pyelocaliceal dilation of the right kidney more frequently than those in the control groups (P < 0.001). It was more frequent in patients having abnormal urinalysis (P < 0.01). Scintigraphy confirmed pyelocaliceal dilation of the right kidney in 38% of patients with abnormal urinalysis. Furosemide renography excluded an obstruction in all of them. CONCLUSIONS: Inflammation is the major cause of abnormal urinalysis and transitory pyelocaliceal dilation in some patients with AA. Erythrocyturia, pyuria, proteinuria, and pyelocaliceal dilation detected by sonography or scintigraphy can frequently be found in patients with AA, but should not mislead the surgeon in the diagnosis of AA.

Prostatitis in benign prostatic hyperplasia: a histological, bacteriological and clinical study.

The paper deals with the incidence of prostatitis in benign prostatic hyperplasia (BPH) and its effect on the postoperative course in the patients subject to the transvesical prostatectomy. The samples of urine and expressed prostatic secretion were bacteriologically analysed before the operation, and samples of urine on three occasions following the operation. Specimens of BPH tissue obtained by surgery were subjected to pathohistological and microbiological examination. The incidence of prostatitis was found to be 90.3%. In the specimens of BPH tissue obtained by transversal prostatectomy, Gram-positive microorganisms were isolated in 32.8% of the tissue. In particular, Staphylococcus epidermidis was found in 26.6% of BPH tissue. Gram-negative microorganisms were isolated in 30.8% of BPH tissue, and fungi in 2.9%. In 27.9% of BPH tissue a microorganism could not be isolated although pathohistological examination evidenced prostatitis. Therefore, in these cases etiology remained unclear. Patients with Gram-negative prostatitis had the highest number of complications and the longest period of postoperative hospitalization. Preoperative and postoperative antibiotic therapy reduced the incidence of postoperative complications and shortened the period of hospitalization in the patients with significant Gram-negative bacteriuria before operation, that is, in the patients with Gram-negative prostatitis in BPH.

[Are Aeromonas species a cause of diarrheal diseases in Yugoslavia?]. / Da li je Aeromonas specijes uzrocnik dijarealnog oboljenja kod nas.

Isolation and identification of Aeromonas spp. have been performed in 1,610 stools in the period from January 1987 to April 1988. Of 1300 stool specimens taken from the patients with diarrheal syndrome (540 stools of children and 760 stools of adults) Aeromonas spp. were isolated only in 4 patients (0.30%, P less than 0.001). Positive stools were found in 3 adult patients and one child. In 310 examined stools of healthy adult persons Aeromonas spp. were not isolated. A significantly higher incidence of Aeromonas species has been observed in different kind of water. They were isolated in 58.3% in waste water, in 56.2% in river water and in 22.2% in well water. The results have shown that Aeromonas species are not important causative agents of diarrheal syndrome in our country but their importance for public health regarding their high distribution in the nature necessitate their further studies.