Catheter-associated urinary tract infections (CAUTIs) are the most prevalent nosocomial infections. These infections impose a significant financial burden on the healthcare system and are responsible for approximately 15,000 deaths each year in the US. CAUTIs are caused by free-floating bacteria that adhere to the surface of Foley catheters and the patient's uroepithelium, forming protective biofilms that enhance bacterial survival and resistance. In this study, a nitric oxide (NO)-releasing liquid formulation is used to inflate the Foley catheter balloon, aiming to inhibit biofilm formation and reduce the risk of CAUTIs. The solution of S-nitrosoglutathione (GSNO), an endogenous NO donor molecule, was used as the catheter inflation fluid. To assess the NO-release profile, the GSNO was dissolved in various pH-adjusted (pH 6.5) aqueous media (deionized water, phosphate-buffered saline, and 2-[4-(2-hydroxyethyl)piperazine-1-yl]ethanesulfonic acid [HEPES] buffers). The GSNO/HEPES formulation sustained NO fluxes through the inflated balloon wall above 0.5 × 10[-10] mol·min[-1]·cm[-2] for up to 10 days, as well as significantly reduced the planktonic bacteria counts and surface colonization against Escherichia coli. The safety of the optimized GSNO formulation was evaluated in vivo in a 7-day preclinical porcine model. The formulation showed no signs of NO-related toxicity. Overall, this study presents a promising, translatable approach to substantially reducing the risk of CAUTIs in healthcare settings.

Recurrent urinary tract infections in children represent a common clinical challenge associated with repeated antibiotic exposure and rising antimicrobial resistance. These limitations have intensified interest in non-antibiotic preventive strategies, particularly nutritional bioactives capable of modulating host-microbe interactions. This review provides a clinically oriented synthesis of current evidence on dietary and nutraceutical interventions for the prevention of recurrent pediatric urinary tract infections. Particular attention is given to the limited availability of high-quality pediatric-specific evidence and the heterogeneity of current clinical data. It focuses on cranberry-derived type A proanthocyanidins, probiotics, selected micronutrients and D-mannose. Key mechanistic pathways are also highlighted, including inhibition of uropathogen adhesion, microbiome-mediated biotransformation of bioactives into anti-inflammatory metabolites, and modulation of host immune and epithelial responses within the gut-bladder axis. Available evidence suggests that cranberry products standardized to deliver approximately 36 mg/day of type A proanthocyanidins may reduce recurrence risk, whereas probiotics and vitamins A, C, and D may provide adjunctive benefits through microbiome modulation and enhancement of innate immune responses. However, substantial heterogeneity in study design, variability in formulations and dosing, and the limited availability of high-quality pediatric randomized trials remain important limitations. Building on current evidence, we propose a pragmatic multimodal framework for non-antibiotic prevention in children that integrates nutritional strategies with clinical risk stratification and individualized care, with particular attention to bioavailability, dose standardization and pediatric-specific factors such as age-related microbiome maturation. Future research should prioritize biomarker-driven endpoints, microbiome-informed stratification and adequately powered pediatric studies to define responders and optimize personalized prevention strategies.

Urogenital myiasis is a rare parasitic infestation caused by dipteran larvae and is infrequently reported in non-endemic regions. This case report documented the first diagnosed case of Psychoda albipennis-induced urinary myiasis in a 41-year-old man from Sanandaj, Iran. The patient presented with dysuria and recurrent passage of mobile black-grayish particles in his urine over 2 months, following prolonged exposure to freshwater environments during fishing activities in Kermanshah Province. Morphological examination of the expelled larvae confirmed identification of P. albipennis using standard taxonomic keys, with emphasis on characteristic morphological structures. Laboratory analyses, including urinalysis and hematological profiling, ruled out bacterial infections, and imaging studies revealed no urinary tract abnormalities of the urinary tract. Treatment with oral ivermectin (200 µg/Kg) along with adequate hydration resulted in symptom resolution and cessation of larval excretion. Clinical symptoms subsided within 48 hours, and no larvae were observed in the urine after 1 week. This case underscored the facultative role of P. albipennis in urogenital myiasis, potentially associated with environmental exposure and compromised hygiene conditions. It highlighted the diagnostic challenges in differentiating myiasis from conventional urinary infections and emphasized the need for increased clinical awareness in regions with suboptimal sanitation. The findings supported the implementation of integrated public health strategies, including improved sanitation infrastructure and community education, to mitigate the risk of infestation. Further studies incorporating molecular diagnostic methods are recommended to enhance species-specific identification and epidemiological surveillance, particularly in resource-limited settings.

Given the increasing prevalence of multidrug-resistant opportunistic pathogens and the high mortality rate associated with delayed diagnosis of disseminated infections, there is an urgent need for rapid diagnostic tools and closely monitored, individualized anti-infective strategies. This study aimed to explore the critical role of comprehensive pharmaceutical care in managing disseminated Nocardia infections complicated by complicated urinary tract infection (cUTI). Through detailed documentation of a 67-year-old male patient, this study focuses on optimizing antimicrobial regimens based on pathogenetic findings and adjusting treatments for severe adverse reactions. The patient was diagnosed with disseminated Nocardia brasiliensis infection complicated by Enterococcus faecalis urinary tract infection using metagenomic next-generation sequencing (mNGS). The treatment process underwent two critical adjustments. First, during the efficacy optimization phase, the initial empirical meropenem therapy was modified to a reinforced regimen centered on trimethoprim-sulfamethoxazole (TMP-SMX), combined with linezolid and short-term amikacin, effectively controlling the spread of infection. Subsequently, during the safety optimization phase, the patient developed severe thrombocytopenia during sequential oral therapy. Prompt identification and switching to amoxicillin/clavulanate potassium resolved the adverse reactions, enabling successful continuation of subsequent treatment. Follow-up revealed a favorable patient recovery. This case demonstrates that for such complex mixed infections, rapid pathogen diagnosis represented by mNGS serves as the starting point for precision treatment, whereas the intensive combination regimen centered on TMP-SMX forms the foundation for controlling disseminated Nocardia infection. More importantly, the core insight from this case is that successful treatment relies not only on appropriate initial medication, but more critically, on proactive, dynamic pharmaceutical monitoring throughout long-term therapy. This enables early intervention for severe adverse drug reactions and timely, flexible adjustments to treatment regimens, which are essential components for ensuring ultimate therapeutic success in patients with such complex infections.

Adipose tumors are common in older dogs. Most of these tumors present as benign subcutaneous lipomas; however, intracavitary lipomas, particularly those within the retroperitoneal space, are rarely documented in veterinary medicine. This case report describes a 14-year-old spayed mixed-breed dog with a history of recurrent urinary tract infections, hind-limb weakness, and prior subcutaneous lipomas that was presented because of polyuria, polydipsia, and behavioral changes. Abdominal ultrasound and subsequent computed tomography revealed a left-sided perirenal mass with fat, fluid, and soft-tissue components. Given the mass's location, vascularity, and associated organ displacement, malignant differential diagnoses were prioritized. Exploratory laparotomy with left nephrectomy and adrenalectomy was completed due to the mass's indistinct margins. Histopathology revealed a benign perirenal lipoma with necrosis, inflammation, and abscessation. The embedded adrenal gland was histologically normal. Postoperative azotemia developed but later stabilized. This case represents a rare instance of a benign retroperitoneal lipoma closely associated with renal and adrenal structures, mimicking more aggressive pathology on imaging. To the authors' knowledge, this may be the first reported case of perirenal lipoma in a dog. Although uncommon, intracavitary lipoma should be considered as a differential diagnosis of retroperitoneal masses, to better inform treatment decisions and prognoses. Key clinical message: This case highlights the rare occurrence of a perirenal lipoma in a dog, emphasizing the importance of considering benign adipose tumors in the differential diagnosis of retroperitoneal masses, even when imaging suggests malignancy. Early recognition can guide more informed treatment decisions and improve patient outcomes.

Adult colonic intussusception is rare and often associated with malignancy; however, the underlying lead point may remain occult on initial imaging. We report a 75-year-old woman presenting with two weeks of right lower quadrant pain, initially managed as a urinary tract infection. Computed tomography (CT) demonstrated colonic intussusception without bowel obstruction or a clearly identifiable lead point. Given the patient's stable condition, non-operative reduction was attempted. A CT-guided water-soluble contrast enema resulted in resolution of the intussusception and revealed a caecal mass not identified on initial imaging. The patient subsequently underwent planned surgical resection for caecal adenocarcinoma. This case highlights the diagnostic value and potential temporary therapeutic role of contrast enema in selected adult patients, facilitating identification of an underlying pathology without delaying definitive treatment.