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논문분류	춘계학술대회 초록집
제목	Urachal Remnant Infection as an Unusual Cause of Fever in a Patient Undergoing Hemodialysis
저자	Sungjin Chung* 1, Min Young Kim1, Eun Sil Koh1, Hyung Do Cho2, Yoon Sik Chang1, Dong Jin Chung3
출판정보	2016; 2016(1):
키워드	End-stage renal disease, Fever, Hemodialysis, Infection, Urachus
초록	Background: The urachus is an embryonic tract that extends upward from the dome of the bladder toward the umbilicus and remnants of the tract are rare in adults. Occasionally, these structures can be infected, and require the prompt diagnosis and sometimes surgical treatment. Methods: We report here a case of urachal remnant infection as an unusual cause of fever in a patient with end-stage renal disease on hemodialysis. Results: A 59-year-old woman, who had been on hemodialysis because of irreversible renal failure due to recurrent vesicoureteral reflux and pyelonephritis, was referred for evaluation of fever and myalgia of unknown origin for 2 weeks. On physical examination, she reported abdominal tenderness in the suprapubic regions. Abdominal computed tomography (CT) revealed a 3.1 cm, irregularly rounded, soft mass with fluid collection at the superior aspect of the bladder. Subsequent ultrasound-guided biopsy of the mass showed a fragment of smooth muscle tissue surrounded by infiltration of inflammatory cells and eosinophils. These findings were consistent with an infected urachal remnant. After a 4-week antibiotic treatment, the patient had resolution of fever, and follow-up CT demonstrated the almost entire regression of the enlarged urachal remnant. Conclusion: This case draws attention to the rare diagnosis of infected urachal remnant as an unusual cause of fever and illustrates the importance of detailed physical examination in determining the correct diagnosis.
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