The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2021.1922832 · Published: November 1, 2022
Pyocystis, a bladder infection common in anuric patients, can trigger autonomic dysreflexia (AD) in spinal cord injury (SCI) patients. This case report explores treating pyocystis with a single dose of amikacin directly into the bladder. A 59-year-old male with paraplegia and anuria experienced recurrent AD suspected to be caused by pyocystis. Traditional IV antibiotics were unlikely to reach the infection site, leading to the decision to use intravesical amikacin. After a single dose of amikacin instilled directly into the bladder, the patient's bladder culture showed no growth, and he remained stable without AD symptoms for one month, suggesting the effectiveness of this treatment approach.
Intravesical amikacin instillation can be a viable treatment option for pyocystis in anuric SCI patients when systemic antibiotics are unlikely to penetrate the bladder epithelium.
Clinicians should consider pyocystis as a potential cause of autonomic dysreflexia in SCI patients with anuria, especially when there is no obvious source of AD.
Intravesical antibiotic instillation offers an alternative to systemic antibiotics, reducing the risk of systemic toxicities while effectively targeting the infection site in the bladder.