Calcifying pyelitis: Puzzling sonographic appearance of urothelial calcifications in chronic urinary tract infection by urea-splitting bacteria

A 74-year-old male patient developed renal failure because of urinary obstruction of his left kidney, the right kidney was atrophic. Computed tomography showed nephro- and urolithiasis; sonography disclosed excessive calcinosis of the renal pyramids, after occlusion of an ureteral stent, also calcification or the renal pelvic urothelium could be visualized. An internet search (google) revealed encrusting pyelitis as the probable cause of the calcifications, indeed, urinary pH was repeatedly increased, and microbiologic examination showed corynebacterium urealyticum urinary infection. Chronic urinary tract infect…