Renal and perinephric abscesses are rare but potentially life-threatening complications of urinary tract infections (UTIs), especially in patients with diabetes mellitus. Diagnosis is often overlooked and delayed due to nonspecific clinical features and incomplete response to antimicrobial therapy. We report a case of a 62-year-old female with a history of poorly controlled type 2 diabetes mellitus (T2DM) who presented with flank pain, dysuria, vomiting, and fever. Imaging with contrast-enhanced computed tomography of the kidneys, ureters, and bladder (CT KUB) revealed right-sided acute pyelonephritis with an abscess in the mid-pole measuring over 5 cm, extending into the perinephric space. In spite of initial intravenous (IV) antibiotics, persistent clinical symptoms and elevated inflammatory markers required broad-spectrum antibiotics and image-guided percutaneous drainage. Culture of the abscess grew Klebsiella Pneumoniae, consistent with a urinary source of infection. Following drainage and targeted antibiotic therapy, the patient showed significant improvement in symptoms and inflammatory parameters, with complete recovery on follow-up. This case emphasizes the significance of early imaging, rapid emphasis on antibiotic use, and punctual percutaneous drainage in diabetic patients with recurrent UTIs to prevent septic complications and long-term renal damage.

A 59-year-old male with decompensated cirrhosis presented with shortness of breath, melena, and progressive dysuria. Clinical examination revealed tender, enlarged prostate. Computed tomography identified a prostatic abscess measuring 2.3 × 2.4 × 2.5 cm. Transrectal ultrasound-guided aspiration yielded purulent material. Culture isolated Salmonella enterica serovar Typhi and multidrug-resistant Escherichia coli. Despite acute kidney injury and multiple comorbidities, patient was successfully treated with dose-adjusted meropenem for two weeks. Following infection resolution, he underwent liver transplantation without recurrence despite immunosuppression. This case highlights the importance of considering typhoidal Salmonella in prostatic abscesses, particularly in immunocompromised hosts.

Ureteral stent placement following ureteroscopic lithotripsy (URL) reduces obstruction but increases the risk of urinary tract infection (UTI). Conventional antibiotic therapy alone is often insufficient. Ningmitai capsule, a traditional Chinese herbal preparation, has demonstrated anti-inflammatory and antibacterial activity. This study evaluated the efficacy, safety, and translational value of combining Ningmitai with cefoxitin. A retrospective controlled study included 76 patients who developed UTI after URL with stent placement between May 2023 and October 2024. Patients were stratification-matched to a cefoxitin-only group (n = 38, cefoxitin only) or a combined group (n = 38, cefoxitin plus Ningmitai). Clinical efficacy, urinary symptom scores, inflammatory markers [high-sensitivity C-reactive protein (hs-CRP), interleukin-1β (IL-1β), procalcitonin (PCT)], and adverse reactions were compared. Logistic regression identified independent predictors, and decision curve analysis (DCA) assessed clinical net benefit. The combined group achieved a higher efficacy rate than the cefoxitin-only group (94.74% vs. 78.95%, p = 0.042). Dysuria, urinary frequency, hematuria, and renal colic improved more significantly, and hs-CRP, IL-1β, and PCT levels decreased to a greater extent in the combined group (all p < 0.001). Combination therapy was an independent predictor of success (OR = 4.52, 95% CI: 1.56-13.06). The predictive model improved AUC from 0.71 to 0.91. DCA showed superior net benefit between 0.1-0.5 thresholds. Adverse events were rare and comparable between groups. Ningmitai capsule combined with cefoxitin improves symptoms, reduces inflammation, and maintains safety in stent-associated UTI after URL. Predictive modeling and DCA confirm its translational potential as an integrative therapeutic approach.

Introduction. Reactive infectious mucocutaneous eruption (RIME) is a phenomenon that occurs predominantly in children and young adults following a bacterial or viral respiratory infection. RIME is most associated with Mycoplasma pneumoniae and generally presents with extensive mucosal and limited cutaneous involvement. Less commonly, infection with Chlamydia pneumoniae can trigger cutaneous eruptions but seldom leads to isolated mucosal involvement. Here, we describe a rare case of RIME mucositis secondary to C. pneumoniae respiratory infection. Case report. An otherwise healthy 19-year-old male presented with fever, cough, conjunctivitis, dysuria and oral mucositis with ulceration preventing food intake. C. pneumoniae was detected on a nasopharyngeal swab by a commercial multiplex PCR (BioFire Respiratory 2.1 Panel), while a broad workup of alternative infectious and autoimmune causes was unremarkable. Despite supportive care, antibiotics and initial steroid treatment, his mucositis necessitated hospital admission and eventually steroid regimen intensification before fully resolving. Conclusion. While rare, C. pneumoniae should be considered as a possible trigger of RIME in adolescents and young adults. Multiplex PCR assays capable of detecting atypical pneumonia pathogens such as C. pneumoniae and M. pneumoniae can assist in diagnosing patients presenting with RIME-compatible symptoms. Treatment involves supportive care, antibiotics and steroids if mucositis is severe. Steroid escalation may be beneficial in patients with slow-resolving mucositis.

A 59-year-old female patient was admitted due to a vaginal mass detected one month ago. There is no family history of malignant tumors, nor any relevant complications. One month prior, she incidentally palpated a cystic mass on the anterior vaginal wall while bathing. She reported no dysuria, hematuria, abdominal pain, or vaginal bleeding. Over the past week, she developed dysuria with interrupted urine flow, but no frequency or urgency. Pelvic MRI revealed a cystic-solid mass in the anterior vaginal wall with indistinct borders from the urethra. Needle biopsy of the vaginal mass combined with immunohistochemistry initially suggested clear cell adenocarcinoma. Final diagnosis was confirmed as primary urethral clear cell carcinoma by pathological examination of the radical resection specimen. Cystic masses in the anterior vaginal wall should raise suspicion for urothelial origin clear cell carcinoma. Fine-needle aspiration biopsy combined with immunohistochemistry may still yield misdiagnosis; definitive diagnosis relies on pathological examination of resected specimens.

BACKGROUND Stevens-Johnson syndrome (SJS) is a rare, immune-mediated mucocutaneous disorder usually triggered by medications or infections. It typically manifests with widespread epidermal detachment and mucosal ulcerations, but atypical cases can present with isolated mucosal involvement, leading to diagnostic uncertainty and delayed treatment. Recognizing such varying presentations is crucial to precent progression to more severe disease and improve outcomes. CASE REPORT We present the case of an 18-year-old male with no significant medical history who presented with severe odynophagia, oral ulcerations, conjunctivitis, and dysuria shortly after completing a course of cefdinir for an upper respiratory infection. Notably, he lacked the characteristic diffuse rash seen in classic SJS. Laboratory evaluation revealed elevated inflammatory markers, and imaging demonstrated non-specific soft tissue edema. Initial management included cessation of cefdinir, intravenous fluids, corticosteroids, and broad supportive care. During hospitalization, he developed macular lesions on the palms and soles and progressive mucosal sloughing. Serologic testing later confirmed elevated Mycoplasma pneumoniae IgM and IgG titers, leading to reclassification of this condition to Mycoplasma pneumoniae-associated SJS (MP-SJS). He was treated with intravenous immunoglobin and azithromycin, with gradual improvement and full recovery after a 2-week hospital course. CONCLUSIONS This case highlights an atypical, mucosal-predominant presentation of Mycoplasma pneumoniae-associated SJS in an adolescent male, initially mimicking severe oropharyngeal infection. Clinicians should maintain a high index of suspicion for SJS in patients presenting with acute mucositis and odynophagia following recent medication use or respiratory illness, even when the cutaneous findings are absent. Early identification, withdrawal of the offending agent, and prompt multidisciplinary care are critical to favorable outcomes.