A 72-year-old male patient with a history of coronary heart disease, chronic renal failure on hemodialysis for 5 years and obstructive uropathy, with a cystostomy five years ago, was hospitalized in the service of internal medicine to perform a change of colliv
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Among the medications that the patient used chronically, none that could be related to the change in color of the urine stood out.
On physical examination, the patient was in good general condition, afflicted, hemodynamically stable, with functioning in situ cystostomy, but with signs of poor self-care, dirty and very bad odor.
A urinary sediment was requested, which showed leukocytes 5-10 x field [normal value]: 1- abundant bacterial and amorphous phosphates x field.
The complete urine test highlighted the color and turbidity, pH 7.8 [VN: 4.5-8.0] and positive nitrites.
The urocultiva revealed a count greater than 100,000 CFU/ml of cefadoxime-resistant Citrobacter freundii, ciprofloxacin and nitrofurin.
Among the blood tests, leukocytosis of 10,600 x mm3 [VN: 4,000-9,000], a CRP of 34 mg/dL [VN: 0 - 2 h [VHS of 54 mm] stood out.
A prostatic ultrasound was performed, a procedure that was technically limited by partial bladder dysfunction, with a volume at the time of study of 26 cc, in which it was not possible to evaluate the prostate gland.
Antibiotic treatment with ceftriaxone 2 g/day intravenous was initiated and urology evaluation was requested, who undertook a change of cystostomy in the context of urinary infection and the aspect poor care.
Over the course of the days, progressive clearance of urine color was observed, returning to its natural color after 7 days of antibiotic therapy.
