case_images: PMC8083874_01
case_images: (A) Abdominal CT revealed renal calculus and hydronephrosis, and pelvic CT revealed lower shift of bladder (red arrow) and severe uterine prolapse (white arrow). (B,C) Abdominal CT showed emphysematous pyelonephritis (white triangle), and pelvic CT showed emphysematous cystitis (red triangle).
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case_images: PMC8083874_01_fmed-08-658682-g0001.jpg
case_images: F1
case_images: As shown in Figure 1A, her abdominal and pelvic computed tomography (CT) on admission revealed renal calculus, hydronephrosis, lower shift of bladder, urinary tract and severe uterine prolapse. In addition, as shown in Figures 1B,C, she suffered from emphysematous cystitis and pyelonephritis both of which contained some gas inside the organ.
case_images: (A-C) Abdominal and pelvic CT taken 10 days after admission. Abdominal and pelvic CT revealed that hydronephrosis was improved, although renal calculus was observed. In addition, pelvic CT revealed that lower shift of bladder (red arrow) and severe uterine prolapse (white arrow) were improved.
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case_images: F2
case_images: In addition, pelvic CT revealed that lower shift of bladder (red arrow) and severe uterine prolapse (white arrow) were improved (Figures 2A-C).
case_images: Time course of clinical parameters in this subject. After prolapsed uterus reduction, ureteral stenting and starting antibiotics, her inflammation markers were markedly improved. She was transferred from intensive care unit to general ward at day 10. After then, her renal function and inflammatory markers were gradually normalized and she was finally discharged about 1 month after admission.
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case_images: F3
case_images: After then, we stopped meropenum and started 3.0 g/day of cefazolin, and after several days later we changed cefazolin to 300 g/day of cefdinir (Figure 3).