Obstructive pyelonephritis caused by the accidental malpositioning of a urethral catheter into the ureter: A case report
Hiroshi Ito,
Toshiya Nakashima,
Jura Oshida,
Taisuke Kodama,
Sayato Fukui,
Daiki Kobayashi
Affiliations
Hiroshi Ito
Corresponding author. Division of General Internal Medicine, Department of Internal Medicine, Tokyo Medical University, Ibaraki Medical Center 3-20-1 Chuo, Ami-machi, Inashiki-gun, Ibaraki, 300-0395, Japan.; Division of General Internal Medicine, Department of Internal Medicine, Tokyo Medical University Ibaraki Medical Center, Japan
Toshiya Nakashima
Division of General Internal Medicine, Department of Internal Medicine, Tokyo Medical University Ibaraki Medical Center, Japan
Jura Oshida
Division of General Internal Medicine, Department of Internal Medicine, Tokyo Medical University Ibaraki Medical Center, Japan
Taisuke Kodama
Division of General Internal Medicine, Department of Internal Medicine, Tokyo Medical University Ibaraki Medical Center, Japan
Sayato Fukui
Division of General Internal Medicine, Department of Internal Medicine, Tokyo Medical University Ibaraki Medical Center, Japan
Daiki Kobayashi
Division of General Internal Medicine, Department of Internal Medicine, Tokyo Medical University Ibaraki Medical Center, Japan
Background: Indwelling urethral catheters can sometimes be accidently inserted into the ureter, which impedes urine flow. Case report: We report a 74-year-old Japanese woman with neurogenic bladder who visited to our hospital due to fever. She was diagnosed as pyelonephritis based on her symptoms and laboratory findings, including pyuria. Abdominal computed tomographic scan showed an indwelling urethral catheter accidently malpositioned into a right ureter, caused ureteral dilatation, and hydronephrosis. Her urethral catheter was replaced, and she was successfully treated with piperacillin-tazobactam and cefotiam. Why should an emergency physician be aware of this?: Urethral catheter malpositioning into the ureter may be asymptomatic and overlooked in patients with neurogenic bladder, which can result in obstructive pyelonephritis. Prompt urethral catheter replacement is essential in treating such conditions.
