A 58-year-old woman with recurrent urinary tract infections presents with acute left flank pain and gross hematuria. Vital signs show BP 138/82, HR 94, RR 18, temperature 37.8°C, SpO2 98% on room air. Urinalysis demonstrates pH 8.5, numerous struvite crystals, and pyuria; serum creatinine is 0.9 mg/dL. CT scan reveals a branching staghorn calculus filling the left renal pelvis. She denies dysuria. Which organism most likely caused these recurrent infections?
- A)Klebsiella pneumoniae
- B)Escherichia coli
- C)Enterococcus faecalis
- D)Pseudomonas aeruginosa
- E)Proteus mirabilisGABARITO
Explicação
Proteus mirabilis is correct. Proteus is urease positive and hydrolyzes urea to ammonia, alkalinizing the urine and promoting magnesium ammonium phosphate stone formation. Staghorn or struvite calculi in the setting of recurrent urinary infection are the key c... Ver explicação completa e trilha adaptativa →