[PAGID] CGD and bladder wall thickening

[Chris Seroogy]

We have a 4y/o boy with X-linked CGD and a right wall bladder thickening,
dysuria and hematuria.  Culture negative, ESR normal and afebrile.

The imaging consisted of U/S and CT with contrast.  It does not have the
characteristics of a rhabdo and given his age in situ carcinoma is rare.  I
am inclined to assume this is non-infectious granulomatous disease and treat
with oral steroids.  His history is notable for gastric antrum granulomas
this past Fall responsive to oral steroids and aspergillus pneumonia at
presentation 3 years ago.

My questions:


1. Would people be comfortable with empiric steroid treatment or is the
risk/invasive nature of cytoscopy with bx/culture warranted?

2. Should empiric antibiotics be started?  If so, what regimen?

Thank you for your thoughts! Chris



Chris Seroogy, M.D.

Assistant Professor

Dept. of Pediatrics

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Madison, WI  53792

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