Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 74-year-old woman was admitted because of abdominal pain. A few weeks before this admission she had had a cerebral infarction in the right hemisphere, reflected by a left sided paralysis, dysarthria, depression and a slight cognitive disorder. The night before admission she woke up from a sharp, continuous pain in the right upper abdomen. Physical examination disclosed pain in the right upper abdomen on palpation. Laboratory tests showed a slight elevation of all 'liver' enzymes. A differential diagnosis of cholecystitis or pyelonephritis was made. Additional tests did not confirm either of these diagnoses. Because of immobilisation pulmonary embolism was then suspected. This diagnosis was confirmed by scintigraphy. The patient was treated and made a full recovery. Diagnostic errors can be made by faulty triggering and omitting verification. The diagnostic strategy for pulmonary embolism is a ventilation perfusion scan, which is followed in case of a non high-probability result by pulmonary angiography. It is emphasized that the presentation of pulmonary embolism can be aspecific.
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PMID:[Clinical thinking and decision making in practice. A patient with pain in the upper abdomen]. 1006 38

Clean intermittent catheterization is a well-known procedure of urinary drainage for patients who are unable to empty the bladder sufficiently. However, some patients with bladder dysfunction and nocturnal polyuria fail to obtain the benefits of intermittent catheterization and have annoying symptoms of nocturnal incontinence and low-compliance bladder, which threaten both their quality of life and renal function. We report the usefulness of nocturnal urethral indwelling catheterization using a specially designed catheter to treat patients (three women) with lower urinary tract dysfunction and nocturnal polyuria. Case 1: A 45-year-old woman with mental retardation suffered from difficulty of micturition and residual urine. A nocturnal urethral indwelling catheter freed her from difficulty with micturition and residual urine. Case 2: A 28-year-old woman with spina bifida and neuropathic bladder dysfunction suffered from urinary incontinence and recurrent pyelonephritis. The recurrent pyelonephritis was prevented and bladder compliance was improved with use of the nocturnal urethral indwelling catheter. Case 3: A 66-year-old woman with cervical myelopathy and multiple episodes of cerebral infarction suffered from nocturnal urinary incontinence. She underwent clean intermittent catheterization by her husband. Use of the nocturnal urethral indwelling catheter solved the problem of her nocturnal incontinence and relieved her husband of her nocturnal care. Nocturnal urethral indwelling catheterization is useful for treatment of nocturnal incontinence and recovery of bladder compliance in patients with lower urinary tract dysfunction and nocturnal polyuria.
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PMID:[Usefulness of nocturnal urethral indwelling catheter for treating bladder dysfunction with nocturnal polyuria: case report of 3 women]. 1262 79

We report a case in which retroperitoneoscopic pyelolithotomy was the procedure selected to treat a large stone in the upper urinary tract. A 71-year-old woman who had multiple cerebral infarction and dementia was admitted with a persistent high fever unresponsive to antibiotics. The diagnosis was pyelonephritis and urosepsis associated with ureteral calculus. A large calculus(3.0 x 2.0 cm)was found in the left ureter at the L3 level. She underwent nephrostomy of the left side. After the patient's general condition had improved, surgery was performed successfully with an uneventful recovery. The findings in this case confirm that retroperitoneoscopic surgery allows removal of a large stone in a single, minimally invasive procedures.
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PMID:Retroperitoneoscopic pyelolithotomy as initial treatment for upper urinary tract large stone. 1604 64

BACKGROUND This is a case report of a male patient who presented with a history of right flank pain based on renal infarction. Initially the symptoms were misdiagnosed as acute pyelonephritis. CASE REPORT A 47-year-old male with a history of familial hypercholesterolemia and cerebral infarction presented at the Emergency Department with a 3-day history of acute right-sided flank pain. Physical examination revealed hypertension, subfebrile temperature, and costovertebral angle tenderness. Blood tests were unremarkable except for renal impairment, a high C-reactive protein level of 215 mg/L (normal <8 mg/dL) and an elevated lactate dehydrogenase (LDH) of 1289 U/L (normal <248 U/L). Renal ultrasonography was normal. He was admitted with a presumed diagnosis of acute pyelonephritis and treated accordingly. However, 2 days later, we rejected this diagnosis as the urine culture was sterile. Based on the acute onset of symptoms and the initial high LDH, renal infarction was suspected. A computed tomography scan confirmed right-sided partial renal and splenic infarctions likely due to spreading emboli from atherosclerosis of the descending aorta. CONCLUSIONS Acute renal infarction is often missed or delayed as a diagnosis because patients often present with flank pain that can resemble more frequently encountered conditions such as pyelonephritis and nephrolithiasis. Renal infarction should be considered in cases with acute flank pain accompanied by (low-grade) fever, high LDH level, increased C-reactive protein level, hypertension, and renal impairment, especially in those patients with an increased risk of thromboembolism.
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PMID:Renal and Splenic Infarction in a Patient with Familial Hypercholesterolemia and Previous Cerebral Infarction. 3053 77