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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Previous experiments in rats have suggested that renal scarring after acute, obstructive pyelonephritis due to Escherichia coli results from parenchymal damage due to acute inflammation and suppuration. To assess the role of acute infiltration by polymorphonuclear leukocytes (PMNLs) in the pathogenesis of chronic pyelonephritis (CPN), rats were either treated with colchicine to depress leukocyte motility or rendered neutropenic with a single dose of cyclophosphamide. Colchicine given during acute pyelonephritis reduced kidney inflammation and protected against CPN two months later. Similarly, neutropenia reduced acute inflammation and protected against chronic parenchymal destruction and scarring. Protection against renal scarring in both colchicine-treated and neutropenic rats occurred despite higher renal bacterial counts during acute pyelonephritis. These experiments provide further evidence that CPN (renal scarring) results from kidney damage that occurs during early acute obstructive pyelonephritis. This damage appears to result from infiltration of the kidney by PMNLs rather than direct damage from bacterial infection.
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PMID:Protection against chronic pyelonephritis in rats by suppression of acute suppuration: effect of colchicine and neutropenia. 710 72

Bladder-aspirate urine samples (N = 428) were cultured for the presence of fastidious microorganisms. These samples were obtained from 190 patients with urinary tract disease or symptoms suggesting infection of the urinary tract in whom standard bacteriologic investigation had failed to indicate bacterial infection. Ureaplasma urealyticum was recovered alone or in association with other microorganisms from the bladder urine of 75% of patients with reflux scarring and abnormal renal function. Ureaplasma organisms were localized to the upper urinary tract in 80% of patients with bladder counts greater than 10(3) colony-forming units per ml. The results indicate that microorganisms not conventionally associated with urinary tract infection are recoverable from the bladder urine of a high percentage of patients with so-called "sterile pyelonephritis," in which group of patients these microorganisms may contribute to progressive renal disease.
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PMID:Unconventional bacteria in urinary tract disease: Ureaplasma urealyticum. 721 69

Magnesium ammonium phosphate calculi developed in the urinary bladders and urethras of four of five offspring of Miniature Schnauzer parents with recurrent struvite urolithiasis. Calculi were detected by radiograhy when the dogs were 12 to 15 months old. Males and females were affected. A significant number of urease-producing staphylococci were identified in the urine of three of four dogs before urolith formation, and in one dog after urolith formation. The dogs were evaluated until they were 26 months old. Serum concentrations of calcium, phosphorus, and magnesium were inside usual limits throughout the study. Abnormalities that might predispose to urinary tract infection were not identified by radiography or necropsy studies. In one dog, bladder calculi recurred after surgical removal of multiple cystoliths. In another, urethral obstruction and acute generalized pyelonephritis induced a lethal uremic crisis. Gross and microscopic lesions, detected after necropsy of all dogs with uroliths, were typical of bacterial infection.
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PMID:Struvite urolithiasis in a litter of miniature Schnauzer dogs. 740 90

Preliminary evidence suggests that the concentration of lactic acid in urine may be a good means of distinguishing lower urinary tract infection (cystitis) from upper urinary tract infection (pyelonephritis) and may be helpful in detecting urinary tract obstruction. To test this hypothesis the lactic acid concentrations in 291 urine samples from 250 children were tested. Sixty-four patients had no bacterial infection and served as the control group. A second group (153 patients) had cystitis, and the third group (24 patients) showed radiologic, clinical, and laboratory evidence of pyelonephritis. A fourth group of nine patients who had prolonged urinary tract retention was also analyzed. Patients in the control group, as well as those with cystitis, showed relatively; low concentrations of urinary lactic acid. All levels were less than 2 mg/dl; (mean, 0.8 mg/dl; range, 0.1-2 mg/dl). Patients who had clinical pyelonephritis had lactic acid concentrations of 3.3 mg/dl (mean, 11.4 mg/dl; range, 3.3 mg/dl-40.5 mg/dl). There was no overlap in lactic acid concentrations between the two groups. Furthermore, lactic acid concentrations in urine from patients who had pyelonephritis gradually declined after the initiation of therapy, attaining a level of less than 1 mg/dl by the end of the treatment. Recurrence of the pyelonephritis was consistently documented by a renewed increase of urinary lactic acid concentration. Lactic acid levels were also elevated in urine samples collected immediately after relief of obstruction in the nine patients who had urethral obstructions, showing a mean concentration of 15.8 mg/dl (range, 4.2-37.2 mg/dl).
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PMID:Lactic acid in urine of children with lower and upper urinary tract infection and renal obstruction. 745 19

We studied the cellular and humoral events which follow experimental acute pyelonephritis from P-fimbriated Escherichia coli to gain insight into the relationships among cells and specifically cytokines to determine how early events in untreated infection lead to renal damage. Cynomolgus (Macaca fascicularis) monkeys were studied after they were subjected to unilateral ureteral bacterial inoculation. We evaluated the blood for leukocytosis and studied lymphocyte subsets using flow cytometry and monoclonal antibodies to the subsets and serum, complement, cytokines and antibody titers. Interleukin-1, 2 and 6 and tumor necrosis factor (TNF) were assayed by enzyme-linked immunoadsorbent assay (ELISA), using monoclonal and polyclonal antibodies. Leukocytosis was marked and there were significant elevations in serum cytokines, interleukin-1 alpha, 2 and 6 with only small changes in the level of TNF. Interleukin-2 levels were sustained and may have upregulated the homing receptor for virgin lymphocytes. The studies illustrated the unique relationship between cytokines and lymphocytes and the response to bacterial infection, showing that the inflammatory response is regulated not only by cytokine activity but also by lymphocyte activation.
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PMID:Cytokine and lymphocyte activation during experimental acute pyelonephritis. 761 33

The urinary tract is among the most common sites of bacterial infection and E. coli is by far the most common infecting agent. In patients with urinary catheters in place or structural abnormalities of the urinary tract, Proteus mirabilis is also a frequent isolate. To study virulence of these bacterial species, we have isolated the genes that encode putative virulence factors, constructed specific mutations within these genes, introduced the mutation back into the wild type strain by allelic exchange, and analyzed these mutants for virulence in appropriate in vitro and in vivo models. Specific virulence markers have been identified for strains that cause urinary tract infection. For E. coli, these include P fimbriae, S fimbriae, hemolysin, aerobactin, serum resistance, and a small group of O-serotypes. Redundant virulence factors must be present in these organisms as mutation of the most clearly identified epidemiological marker, P fimbriae, does not result in attenuation of a virulent strain. For P. mirabilis, urease appears to contribute most significantly to virulence. Fimbriae play a significant but more subtle role in colonization. Hemolysin, although potently cytotoxic to renal cells in vitro, does not appear to contribute significantly to the pathogenesis of ascending urinary tract infection. We can conclude that the pathogenesis of urinary tract infection and acute pyelonephritis caused by uropathogenic E. coli and P. mirabilis are multifactorial, as mutation of single genes rarely causes significant attenuation of virulence.
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PMID:Virulence determinants of uropathogenic Escherichia coli and Proteus mirabilis. 786 62

Urinary infections, with a spectrum from covert bacteriuria to severe pyelonephritis, commonly complicate pregnancy. Serious infections follow untreated silent bacteriuria in a fourth of cases, and routine screening can be justified in high-risk populations, particularly in those women from lower socioeconomic strata. Despite an initial salutary response to a number of antimicrobial regimens, covert bacteriuria recurs in one-third of treated women whose risk of pyelonephritis again is at 25%. Acute cystitis may be unrelated to these other infections and responds readily to a number of regimens; however, single-dose therapy is not recommended because early pyelonephritis can be mistaken for uncomplicated cystitis. Pyelonephritis is the most common severe bacterial infection complicating pregnancy. These women are frequently quite ill, and hospitalization is recommended. Since 85-90% respond within 72 h to intravenous fluids and antimicrobials, continued fever and evidence for sepsis should prompt a search for underlying obstruction. Perhaps 20% of women with severe pyelonephritis develop complications that include septic shock syndrome or its presumed variants. These latter include renal dysfunction, haemolysis and thrombocytopenia, and pulmonary capillary injury. In most of these women, continued fluid and antimicrobial therapy result in a salutary outcome, but there is occasional maternal morbidity.
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PMID:Urinary tract infections complicating pregnancy. 792 12

A 2-year-old castrated male vietnamese pot-bellied pig examined because of stranguria was found to have severe dilatation and inflammation of the pelvic portion of the urethra accompanied by cystitis and pyelonephritis. The pig had apparently had chronic inflammation of the urinary tract that eventually progressed to incomplete obstruction of the urethra. However, the initial cause of the urinary tract inflammation could not be determined. Possible causes included chronic bacterial infection, traumatic injury during urethral catheterization, and injury to the urethral mucosa secondary to extreme acidification of the urine.
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PMID:Incomplete urethral obstruction associated with dilatation of the urethra, cystitis, and pyelonephritis in a Vietnamese pot-bellied pig. 944 33

Entropy, as the measure of that part of the heat or energy of a system which is not available to perform work, is suitable for application in numerous medical investigations. It is determined in regard to two states of the system: states above and below the examined level of studied parameters. By application of entropy function in completed examinations sometimes it is possible to gain additional conclusions or to confirm already existing. This method of entropy determination was performed in final quantitative bacteriological and cytological examinations of samples gained from the first morning urine of 314 persons without symptoms or signs of urinary tract infection, 422 patients with symptoms and signs of bacterial infection and 31 deceased persons with autopsy confirmed pyelonephritis. Gathered results confirm the diagnostic and prognostic significance of quantitative bacteriological and cytological urine examination. However, by examination of these findings in patients with pyelonephritis, as well as the nature of bacteria, it can be concluded that the lowest of bacteriuria is between 10(3) and 10(4) in 1 ml of urine.
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PMID:[Entropy in the assessment of diagnostic importance of changes in urine]. 947 27

Bacterial cystitis is the most common bacterial infection occurring in women. Thirty percent of women will experience at least one episode of cystitis during their lifetime. About one third of patients presenting with symptoms of cystitis have upper urinary tract infection. A careful history to identify risk factors for subclinical pyelonephritis is important. Symptoms of chronic cystitis accompanied by sterile urine without pyuria may represent interstitial cystitis. Dysuria may also be the principal complaint of women with vaginitis (infectious, atrophic or chemical) or urethritis. A stepwise diagnostic approach, accompanied by inexpensive office laboratory testing, is usually sufficient to determine the cause of dysuria.
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PMID:The women with dysuria. 960 6


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