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Case Reports
A Diabetic Patient with Prolonged Hyperammonemia Due to Urinary Tract Infection Caused by Urease-producing Bacteria.
- Saori Inoue, Hiroko Yasuda, Kaoru Yoshida, Kazuaki Mori, Koichiro Ogawa, Yoko Yokotsuka, and Hideki Okamoto.
- Meitetsu Hospital, Japan.
- Intern. Med. 2024 Jul 1; 63 (13): 194519491945-1949.
AbstractObstructive tract infection caused by urease-producing bacteria can lead to hyperammonemia. We herein report a 73-year-old woman with diabetes and compensated liver cirrhosis who developed obstructive pyelonephritis. Her consciousness level declined on day 3 of hospitalization. Blood tests revealed an elevated ammonia level of 140 μg/dL. Urine and blood cultures identified Proteus mirabilis as a urease-producing bacterium. The treatment included double J (WJ) catheter insertion and administration of antimicrobial agents. On day 7 of hospitalization, the ammonia level gradually decreased, and the patient's consciousness improved. However, despite these interventions, perinephric overflow of urine persisted, necessitating nephrectomy.
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