Enterococcus faecium is a Gram-positive flora bacterium home to the gastrointestinal tracts of humans. A true ubiquitous pathogen and a member of the intestinal microbiome, formerly known as group D streptococci, this pathogen has been around for over 10 centuries. Enterococcus faecium thrives in the presence of stool and sewage. The ability to cause endocarditis and urinary tract infections (UTIs) has led to morbidity and mortality in the adult population. We report a case of an elderly woman who presented with multiple falls to our trauma bay area. She was initially managed as trauma during multiple visits with superficial scalp lacerations. However, with multiple falls, she was subsequently transferred to medicine to rule out cardiogenic versus neurogenic syncope. She was admitted to the telemetry unit, and a cardiologist was consulted. Orthostatic vitals were negative, and she had no fever or leukocytosis. Abdominal computed tomography (CT) done as part of the standard trauma workup revealed an interesting finding of multiple bladder diverticula.

UNASSIGNED: Large congenital bladder diverticula (LCBD), congenital bladder diverticula (CBD) larger than 2 cm diameter, is a rare anomaly. The aim of this study was to report long-term surgical and clinical outcomes of children with LCBD.
UNASSIGNED: Medical charts of all children who were diagnosed with LCBD at our institution between April 2005 and December 2017, with at least 2 year follow-up were retrospectively reviewed. Patients\' demographics, symptoms, operative technique, diverticulum size and localization, surgical outcomes and complications were recorded.
UNASSIGNED: Fourteen patients with 18 LCBD, all male and age between 7 and 240 months (mean age: 53.5 months) were included in the study. Urinary tract infection was the main complaint in 10. Vesicoureteral reflux was detected in eight patients. Diverticula were 2-5.5 cm (mean 3.3 cm) in size. All diverticulectomies were performed transvesically and ureteroneocystostomy was added in 12 patients, 5 of whom were bilateral. No postoperative infection or recurrent reflux were observed. The median follow-up period was 4.5 years (2-12 years).
UNASSIGNED: Treatment of LCBD is mostly surgical and transvesical approach for diverticulectomy was found to be a safe and effective surgical procedure in long term follow-up.

Bladder diverticula can be either congenital or acquired. They are the formation of a urothelial hernia through the muscle wall fibers of the bladder. Congenital bladder diverticula are rare and there are no previous reports showing them to have been found through an antenatal ultrasound exam revealing the presence of hydronephrosis. Here we describe the case of a large congenital bladder diverticulum revealed through an antenatal hydronephrosis diagnosis and whose proximity to the ureter led to its removal and a ureteral reimplantation.