Arcanobacterium pyogenes and encrusted pyelitis

AIM: Trueperella pyogenes is known to affect cattle, but was never isolated as a cause of human urinary tract infections. CLINICAL CASE: A 69-year-old male presented for recurring low urinary tract symptoms after a 20-day ciprofloxacin regimen for prostatitis. He previously underwent open right nephrolithotomy and left ureterovesical junction reimplantation for an iatrogenic distal ureteral stricture. Computed tomography showed spontaneous cortical calcifications; renoscopy was performed and deep cultures from the pelvis were taken; culture on chocolate agar revealed T. pyogenes. Intravenous teicoplanin for 3 weeks resulted in resolution of low urinary tract symptoms with regression of bladder and ureteral thickening. CONCLUSION: T. pyogenes can cause encrusted pyelitis in humans especially evoked in a context of persisting or recurring urinary tract infections.