The incidence of Corynebacterium urealyticum infection in kidney recipients is low. Its common clinical manifestation is encrusted cystitis or encrusted pyelitis. Herein, we report an unusual case of a 19-year-old kidney recipient with necrotizing pyelitis due to C urealyticum in the absence of mucosal encrustation or calculi. The patient was readmitted 30 days posttransplantation to remove a stent. Cystoscopy demonstrated a normal vesical wall without encrustation. The stent was removed without problems. Culture yielded negative findings. That night, the patient had fever and hematuria. Therapy included forced diuresis with high fluid intake, and diuretic and antibiotic administration. The patient was then discharged. However, 15 days later he was readmitted because of hematuria with a significant decrease in hemoglobin concentration. Echography demonstrated the presence of hyperechogenic material in the pelvis and ureter. Pyelography demonstrated the presence of numerous coagula obstructing the urinary tract. In addition, severe hematuria required transplant nephrectomy.
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