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April 4, 1977

Bacterial Infection of Renal Calculus

JAMA. 1977;237(14):1467-1468. doi:10.1001/jama.1977.03270410067028

SEVERAL conditions have been invoked to explain the persistence of urinary tract infection with a single organism: (1) infection stones, (2) chronic bacterial prostatitis, (3) abnormality of the urinary tract with patient susceptibility to infections.1 The following case report illustrates the unexpected development of persistent urinary infection by the incorporation of bacteria into a preexisting renal calculus, and the use of bacterial localization studies to confirm this phenomenon.

Report of a Case  A 50-year-old man was first seen at the urology clinic in 1969 with gross, painless hematuria and intermittent, mild, leftsided flank pain of several months' duration.Thirty years earlier, he had undergone a left-sided pyelolithotomy. The following year he underwent a right-sided pyelolithotomy. He had been well urologically since that time.In 1968 he began to note occasional midepigastric pain. Results of a gastrointestinal work-up were normal, but kidneys, ureters, and urinary bladder (KUB) x-ray film showed