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Tilfelli mánaðarins : purple urine bag syndrome; PUBS [sjúkratilfelli]

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Authors
Halla Viðarsdóttir
Runólfur Pálsson,
Tómas Guðbjartsson
Issue Date
2008-05-01

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Other Titles
Case of the month; purple urine bag syndrome (PUBS) [case report]
Citation
Læknablaðið 2008, 94(5):383, 385
Abstract
Sjötugur karlmaður með tveggja ára sögu um blöðruhálskirtilskrabbamein leitar á bráðamóttöku Landspítala vegna nokkurra daga sögu um sérkennilegan lit á þvagleggspoka. Frá greiningu krabbameinsins hefur hann verið með þvaglegg vegna þrengsla í blöðruhálsi. Á mynd 1 sést þvagleggspoki mannsins við komu á bráðamóttöku og eru pokinn og slangan sem við hann er tengd greinilega fjólublá að lit. Að öðru leyti hefur hann verið einkennalaus og hefur neytt hefðbundinnar fæðu. Lyf sem hann hefur tekið undanfarið eru atenólól, nífedipín, rabeprazól, metóklópramíð, parasetamól og tramadól. Blóðrannsóknir sýna eðlilegan blóðhag, elektrólýta og kreatínín og vægt hækkað CRP (17 mg/L). Þvagrannsókn leiðir í ljós pH 6,5, 1+ prótein, 3+ blóð og 2+ hvítkornaesterasa og við smásjárskoðun sjást 50-100 rauð blóðkorn, 25-50 hvít blóðkorn og talsvert af bakteríum. Frá þvagi ræktast Morganella morganii og kóagulasa-neikvæður stafýlókokkur í miklum mæli og lítið magn af corynebacterium. Hver er sjúkdómsgreiningin og helstu mismunagreiningar?
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Case of the month (Sjúkratilfelli mánaðarins) Articles in Icelandic

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