A 44-year-old woman with a history of recurrent urinary tract infections presents with fever (38.9°C), dysuria, and left flank pain. Vital signs show BP 128/82 mmHg, HR 102/min, RR 18/min, SpO2 98% on room air. Urinalysis demonstrates alkaline urine (pH 8.2), pyuria, and bacteriuria. Serum creatinine is 1.1 mg/dL. Non-contrast CT imaging reveals a large branching stone completely filling the left renal pelvis. She denies hematuria. Which organism is most likely responsible for this stone type?
- A)Adenovirus
- B)Staphylococcus saprophyticus
- C)Proteus mirabilisGABARITO
- D)Enterococcus faecalis
- E)Escherichia coli
Explicação
Struvite stones are composed of magnesium ammonium phosphate and form in alkaline urine due to urease positive organisms. Proteus mirabilis splits urea into ammonia, raising urine pH and promoting staghorn calculus formation. Ver explicação completa e trilha adaptativa →