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European Journal of Pediatrics Aug 2014Recently, Aerococcus urinae, primarily recognized as a common pathogen in elderly women, has been reported to cause an extremely unpleasant odour of the urine in...
UNLABELLED
Recently, Aerococcus urinae, primarily recognized as a common pathogen in elderly women, has been reported to cause an extremely unpleasant odour of the urine in paediatric patients similar to trimethylaminuria (fish odour syndrome). Herein, we present a case of A. urinae urinary tract colonization in a 12-year-old otherwise healthy boy, who finally refused micturition outside from his home environment as a result of the unpleasant odour. Within the last year, three cases (including our own) of A. urinae colonization causing foul-smelling urine in healthy children have been published, suggesting that this condition might be as frequent as trimethylaminuria. In case of polymicrobial growth in a urine specimen, A. urinae as the leading pathogen will usually be missed by routine bacteriological investigation. Novel bacteriological techniques such as MALDI-TOF MS provide a rapid tool to recognize this pathogen in urine.
CONCLUSION
As treatment of A. urinae infection is simple, we recommend that in healthy children with malodorous urine, this pathogen is excluded before the initiation of costly metabolic investigations.
Topics: Aerococcus; Anti-Bacterial Agents; Child; Gram-Positive Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Odorants; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Urinary Tract Infections; Urination
PubMed: 24913181
DOI: 10.1007/s00431-014-2348-9 -
Revista Clinica Espanola Sep 2011
Topics: Adult; Aerococcus; Endocarditis, Bacterial; Female; Gram-Positive Bacterial Infections; Humans
PubMed: 21794855
DOI: 10.1016/j.rce.2011.01.019 -
Journal of Clinical Microbiology Apr 2000Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identification of the organism. A. urinae is a gram-positive coccus that grows in...
Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identification of the organism. A. urinae is a gram-positive coccus that grows in pairs and clusters, produces alpha-hemolysis on blood agar, and is negative for catalase and pyrrolidonyl aminopeptidase. Some of these characteristics and its being absent from the databases of most commercial identification systems could allow A. urinae to be misidentified as a streptococcus, enterococcus, or staphylococcus. We report two cases of urinary tract infection (UTI) caused by A. urinae and characterize these isolates by morphology, biochemical testing, whole-cell fatty acid analysis, 16S rRNA gene sequencing, and antibiotic susceptibilities. Most patients infected with A. urinae are elderly males with predisposing conditions who present initially with UTI. Because A. urinae is resistant to sulfonamides, treatment could be inappropriate, with infections resulting in serious complications, including death. It is important for the clinician and the microbiologist to consider A. urinae a potential pathogen and proceed with thorough microbiological identification.
Topics: Aged; Aged, 80 and over; Bacterial Typing Techniques; Gram-Positive Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Streptococcaceae; Urinary Tract Infections
PubMed: 10747177
DOI: 10.1128/JCM.38.4.1703-1705.2000 -
Enfermedades Infecciosas Y... May 2024
Topics: Humans; Urinary Tract Infections; Aerococcus; Endocarditis, Bacterial; Gram-Positive Bacterial Infections; Recurrence; Male
PubMed: 38704195
DOI: 10.1016/j.eimce.2024.02.008 -
IDCases 2016Aerococcus urinae is a rare bacteria usually associated with urinary tract infection. It is unusually associated with endocarditis. To date only 18 cases have been...
Aerococcus urinae is a rare bacteria usually associated with urinary tract infection. It is unusually associated with endocarditis. To date only 18 cases have been reported. Among these cases, the majority had aortic valve involvement. Three had mitral and aortic valve involvement, and two had mitral and tricuspid valve involvement. We present the first reported case of A. urinae associated aortic and tricuspid valve endocarditis. Timely recognition and appropriate treatment of this fatal infection is essential to decrease morbidity and mortality.
PubMed: 27051583
DOI: 10.1016/j.idcr.2016.01.007 -
Cureus Mar 2024() infection, primarily observed in elderly patients, is a rare yet emerging occurrence in the pediatric population. Advances in laboratory techniques have facilitated...
() infection, primarily observed in elderly patients, is a rare yet emerging occurrence in the pediatric population. Advances in laboratory techniques have facilitated the increased identification of these bacteria in human infections. There have been only a few recent cases reported among children. The scarcity of literature on the clinical presentation and management of such infections in children presents a challenge for pediatricians. Here, we present the case of a 15-month-old male child with Down syndrome who presented with malodorous urine but lacked other typical symptoms of urinary tract infection. Upon investigation, urine analysis revealed pyuria, and urine culture confirmed infection. The patient also exhibited underlying bilateral mild to moderate hydronephrosis. Successful treatment was achieved with a three-day course of amoxicillin, leading to symptom resolution. This case underscores the significance of promptly identifying infection in pediatric patients presenting with malodorous urine, as a timely intervention with a short course of treatment may avert more severe and invasive infections.
PubMed: 38586679
DOI: 10.7759/cureus.55635 -
European Journal of Clinical... May 1999Three cases of serious infection caused by Aerococcus urinae are presented: a patient with endocarditis and two patients with soft-tissue infection (phlegmon and... (Review)
Review
Three cases of serious infection caused by Aerococcus urinae are presented: a patient with endocarditis and two patients with soft-tissue infection (phlegmon and balanitis respectively). The literature on Aerococcus urinae infections is reviewed and the antibiotic therapy discussed. Aerococcus urinae is a pathogen isolated primarily from urine specimens of elderly patients with local or systemic predisposing conditions. Most infections are mild, but serious infections such as endocarditis and septicemia/urosepsis have been described. Penicillin or ampicillin in combination with an aminoglycoside and close monitoring of the patient's clinical status and laboratory results would seem to be the best strategy for management of cases of serious infection.
Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Balanitis; Endocarditis, Bacterial; Fatal Outcome; Gram-Positive Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Streptococcaceae
PubMed: 10421047
DOI: 10.1007/pl00015022 -
BMJ Case Reports Jul 2016We present the case of an elderly male who was initially seen in our hospital for a urinary tract infection that was treated with oral ciprofloxacin. He was admitted...
We present the case of an elderly male who was initially seen in our hospital for a urinary tract infection that was treated with oral ciprofloxacin. He was admitted 2 weeks later with altered mental status and fever, and was found to have bacteraemia with Aerococcus urinae Owing to altered mental status a brain MRI was performed which showed evidence of embolic stroke. Following this, a transesophageal echocardiogram showed severe mitral regurgitation and a vegetation >1 cm involving the mitral valve with associated destruction of posterior valve leaflets. The patient was started on antibiotics intravenous penicillin G and intravenous gentamicin for a total duration of 6 weeks. He underwent mitral valve replacement on day 4 of hospitalisation. The postoperative course was complicated by ventilator-dependent respiratory failure, requiring tracheostomy and eventual transfer to a skilled nursing facility. Unfortunately, he died after 2 weeks of stay at the facility.
Topics: Aerococcus; Aged; Anti-Bacterial Agents; Brain; Echocardiography, Transesophageal; Endocarditis, Bacterial; Fatal Outcome; Gentamicins; Humans; Magnetic Resonance Imaging; Male; Mitral Valve; Mitral Valve Insufficiency; Penicillins; Stroke; Urinary Tract Infections
PubMed: 27440847
DOI: 10.1136/bcr-2016-215421 -
The American Journal of Medicine May 2024
Topics: Humans; Aerococcus; Urinary Tract Infections; Gram-Positive Bacterial Infections; Anti-Bacterial Agents; Male; Female; Communicable Diseases, Emerging
PubMed: 38320725
DOI: 10.1016/j.amjmed.2024.01.029 -
Case Reports in Urology 2015A 49-year-old male presented to the emergency with hematuria and pain in the shaft of the penis for one day. The patient was found to be in a state of shock. The shaft...
A 49-year-old male presented to the emergency with hematuria and pain in the shaft of the penis for one day. The patient was found to be in a state of shock. The shaft of the penis and the scrotum were swollen and tender. No skin necrosis was observed and no crepitus was palpable. Serum white count (WBC) was 29.5 × 10(3)/μL. A CT scan showed gas in the corpus spongiosum. Antibiotics were started with IV metronidazole, vancomycin, and piperacillin/tazobactam. Metronidazole was then replaced by clindamycin. Exploration was performed but no necrotic tissue was identified. Cystourethroscopy revealed dusky looking urethra. A suprapubic tube and a urethral catheter were placed in the bladder. WBC trended down to 13.9 × 10(3)/μL on the fourth postoperative day. Urine culture grew Aerococcus urinae and blood cultures grew Alpha Hemolytic Streptococcus. On the sixth day, the patient was feeling worse and WBC increased. MRI revealed absent blood flow to the corpus spongiosum. Urethroscopy revealed necrosis of the urethra. Urethrectomy was performed via perineal approach. The patient immediately improved. The patient was discharged on the sixth postoperative day to continue ampicillin/sulbactam IV every 6 hours for a total of 4 weeks from the day of urethrectomy.
PubMed: 26171271
DOI: 10.1155/2015/136147