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The initial six months following HIV infection have a high viral load. Nonspecific presentations might lead to the missing primary HIV diagnosis. Multiorgan and multisystem diagnosis is a rare presentation of primary HIV. A 40-year-old male patient with no documented comorbidities presented with bilateral flank pain. The onset of the pain was gradual, characterized as dull and aching, with radiation toward the groin. The patient also had severe pain in the left shoulder and left ankle region. Per-abdominal examination revealed bilateral flank tenderness, with the right side being more tender than the left. Swelling of the left shoulder and ankle was observed, accompanied by tenderness and a restricted range of motion. Contrast-enhanced computed tomography of the chest and abdomen revealed bilateral pyelonephritis multiple renal abscesses and liver abscesses. Left shoulder septic arthritis was also present. Pus culture and blood culture were positive for methicillin-sensitive Staphylococcus aureus . Antibiotics, according to the culture sensitivity, were given, and retroviral therapy was started from the antiretroviral clinic. Primary HIV infection can present with a variety of signs and symptoms. This case demonstrates that AIDS can affect any organ and mimic other disease processes. The initial clinical picture might be confused with individually occurring diseases; therefore, we should consider AIDS in patients presenting with multiorgan failure. Early initiation of empiric and then culture-specific antibiotics along with antiretroviral therapy helps in the rapid improvement of the patient and controls the high viremia. The infected patient also needs appropriate counseling on ways to avoid high-risk behavior, which may prevent transmission of HIV., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Singh et al.)

Colovesical fistula (CVF) is a rare but potentially serious condition characterized by abnormal communication between the colon and the bladder. This pathology can result from inflammatory diseases, malignancies, or previous surgical interventions, with a significant impact on the patient's quality of life. CVF is associated with high morbidity and mortality rates, particularly in immunosuppressed individuals, such as renal transplant recipients, due to their increased susceptibility to infections and surgical complications. In this case report, we describe a case of a 57-year-old male patient, a renal transplant recipient under chronic immunosuppressive therapy, who developed an enterovesical fistula. The management of CVF in transplant patients poses diagnostic and therapeutic challenges, requiring a multidisciplinary approach to optimize clinical outcomes. The relevance of this case lies in the complexity of treating a severely ill immunosuppressed patient, with few similar cases reported in the literature., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gonzales et al.)

Renal and perinephric abscesses are rare purulent infections within or around renal parenchyma, typically treated with antibiotics or various procedural approaches depending on abscess size. In this case report, we describe the novel use of a transgastric endoscopic ultrasound (EUS)-guided technique with placement of a stent for drainage between a renal abscess and the stomach in a patient who had failed attempted percutaneous drainage twice and where an open surgical approach was deemed inappropriate. The patient presented with a chief complaint of left flank pain, with CT revealing a ~4 x 4 cm renal abscess in the upper pole of the left kidney. Urology, Infectious Disease, and Interventional Radiology were consulted. Following two failed attempts at percutaneous drain placement, the patient elected for EUS-guided transgastric stent placement for drainage. The stent was removed by postoperative day two after significant decompression of the abscess. He was advised to follow up outpatient with Urology to confirm full renal abscess resolution., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Wojtas et al.)

Renal abscess is a rare complication of pyelonephritis known to be linked to recurrent urinary tract infections, anatomical abnormalities, obstruction, and the immunocompromised. Symptoms can be very nonspecific such as fever, chills, and abdominal or flank pain, which makes it more challenging to diagnose; however, this has been made easier with the help of medical imaging. Persistently spiking fevers despite antibiotics should prompt a review for possible abscess formation. We describe a case of renal abscess in a previously healthy young female with no risk factors who was successfully treated with antibiotics and radiologically guided percutaneous drainage., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Chamba et al.)

Mycotic aortic aneurysms (MAAs) are a rare form of aortic aneurysms that are associated with catastrophic outcomes if not diagnosed and treated on time. However, MAAs are a diagnostic challenge owing to their often nonspecific presentation. In this study, we present a case of a 42-year-old female with a pertinent history of intravenous drug use who presented with generalized body pain for two weeks and was found to have a mycotic thoracoabdominal aortic aneurysm (TAAA) extensively involving adjacent structures, including lungs with pleural cavity and upper renal pole. Not only does this case highlight the difficulty in early diagnosis and complex pathology of a mycotic TAAA, but it also illustrates the multidisciplinary approach required to effectively treat them., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Shahid et al.)

The incidence of renal abscesses during pregnancy has not been well-established. A renal abscess is usually secondary to the complications of acute pyelonephritis and can lead to severe consequences, including fetal and/or maternal death. Little is known about the incidence of renal abscesses in pregnant women; however, the literature consistently refers to it as an extremely rare occurrence. We report a case of a large renal abscess discovered in the early postpartum period following a recurrent urinary tract infection and flank pain during pregnancy. The patient was successfully managed with abscess drainage and prolonged antibiotics., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Eze et al.)

Intravesical instillation of bacillus Calmette-Guérin (BCG) is the adjuvant therapy for superficial urothelial carcinoma of the bladder with the lowest recurrence rates and is well tolerated with minor and self-limiting adverse effects. Serious complications, such as systemic BCG infection, are uncommon as the diagnosis is difficult and, in the majority of cases, Mycobacterium bovis  cannot be isolated. We describe a case of a man who presented with prolonged fever associated with polyuria, dysuria, anorexia, and significant weight loss, refractory to several courses of appropriate antibiotic therapy. After an exhaustive investigation, the underlying diagnosis of systemic BCG infection with renal involvement was considered. Antituberculosis treatment resulted in a marked clinical and radiological recovery, supporting this diagnosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Afonso et al.)

Acute focal bacterial nephritis (AFBN) is a radiologically diagnosed acute localized kidney infection that appears in the continuum between a perinephric abscess and renal abscess. We report an unusual case of AFBN presenting without pyuria or positive urine cultures. A 42-year-old woman with chronic lower back pain who regularly used nonsteroidal anti-inflammatory drugs was admitted to our hospital with right-sided abdominal distention, fever, chills, and pain extending from the right lower abdomen to the back since two days. The physical examination revealed no abdominal or costovertebral angle tenderness. Urinalysis was negative. Abdominal ultrasound was notable for an indistinct nodular shadow (32 × 25 mm) on the upper pole of the right kidney. Abdominal contrast-enhanced computed tomography revealed a wedge-shaped area with a minimal uptake of the contrast in the right kidney. The patient was admitted to the hospital, and antimicrobial therapy was started for AFBN. Antibiotics were administered intravenously for one week and orally for two weeks. No relapse of symptoms was observed during the four-month follow-up period. This case report suggests the importance of considering AFBN as a differential diagnosis for cases of idiopathic fever and lateral pain or back pain, even when pyuria and urine culture test results are negative., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Kaneko et al.)

Campylobacter bacteremia and extraintestinal manifestations are extremely rare, occurring more frequently in immunocompromised patients. We report a rare clinical case of a 46-year-old female with common variable immunodeficiency (CVID) presenting with a previously undescribed extraintestinal complication - renal abscess - and recurrent bacteremia caused by Campylobacter , which was a therapeutic challenge and required the use of secondary prophylactic antibiotic treatment to prevent recurrence., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Cameira et al.)

Streptococcus agalactiae  (Group B Streptococcus or GBS)is an exceptionally rare causative organism of a ruptured renal abscess. We report a case of this normally commensal organism causing a large ruptured renal abscess in a 17-year-old postpartum female. Although S. agalactiae is known to cause postpartum neonatal morbidity and mortality, it has rarely caused invasive infections in the last 20 years in adults. While this diagnosis often presents with nonspecific findings that can easily be overlooked during the postpartum period, the patient responded well to the established treatment of broad-spectrum antibiotics and a percutaneous drain., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Wright et al.)