ArticleCureus2025
Urine Gram Stain in the Early Detection of an Enterovesical Fistula.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Enterovesical fistula (EVF) is a rare condition that can be difficult to diagnose due to its nonspecific symptoms, such as recurrent urinary tract infections (UTIs), pneumaturia, and fecaluria. We report a case of EVF in which early diagnosis was facilitated by clinically integrated interpretation of urine Gram stain findings in the context of the patient's overall presentation. An 89-year-old woman with a history of rheumatoid arthritis and long-term corticosteroid use presented with fever and right knee pain, initially suspected to be a rheumatoid flare. However, synovial fluid analysis was negative for infection or crystals, prompting further evaluation. Urinalysis revealed bacteriuria and leukocyturia, and urine Gram stain demonstrated a polymicrobial pattern with numerous polymorphonuclear leukocytes. Given the patient's clinical status and lack of common risk factors for polymicrobial colonization, the findings raised suspicion for fecaluria and a possible EVF. A contrast-enhanced computed tomography (CT) scan subsequently confirmed an EVF due to mucinous adenocarcinoma of the cecum invading the bladder. The patient underwent successful ileocecal resection and bladder fistula closure. Although not routinely used to diagnose EVF, urine Gram stain can provide early diagnostic clues when interpreted in real time alongside clinical findings. When polymicrobial patterns are observed in urine, especially in patients with recurrent or atypical UTIs, they may offer a critical diagnostic clue to EVF. In this case, the integration of polymicrobial patterns with bedside assessment led to early suspicion and imaging. The case also highlights how serious infections in older patients may present with atypical or misleading symptoms, emphasizing the need for diagnostic vigilance. This case highlights the potential utility of urine Gram stains as a rapid, cost-effective tool for the early detection of EVF. Clinicians should consider EVF in older adult patients with atypical UTIs, and interpret polymicrobial Gram stain findings in the clinical context to guide timely diagnosis and appropriate management.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.