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)

In 4 out of 9711 (= 1:2400) patients, lactice acidosis due to biguanides was diagnosed. Serum lactate concentration averaged 18.2 mmol/l and the pH value 6.87. All patients showed signs of renal insufficiency and three had congestive heart disease. In addition to treatment with biguanides, other factors might have contributed to the lactice acidosis in these patients: prolonged fasting, severe dehydration due to persistent vomiting, acute bronchopneumonia, and acute pyelonephritis. On addmission, two patients were in shock and all patients were semi-conscious or comatose. All patients were treated with bicarbonate and glucose/insulin. One patient was hemodialysed. Two of our four patients died. Oour four patients are compared with 179 patients in the literature with respect to mortality and prognosis of lactic acidosis due to biguanides.
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PMID:[Lactacidosis in biguanide therapy: diagnosis and therapy. 4 cases compared to 179 cases in the world literature]. 71 23

In a comparative period of 20 years is reported on the frequency of diabetes mellitus in urological diseases. It was found that 0.87% of the patients suffer from a concomitant diabetes. The peak of the disease is between the 60th and 70th year. As to the distribution of sex was established that the concomitant diabetes is to be found more frequently in males (ratio 2.4: 1). The lethality in diabetics with a urological disease is with 9.4% more than twice as high as in the other urological patients (4.3%). At the top of the immediate causes of death is the cardiovascular failure (30.7%), followed by the pulmonary blood clot embolism and the uraemic coma with 15.4% each. A diabetic coma never appeared. In the analysis of the urological diseases with concomitant diabetes the lithiasis (34.4%) is in the first place; then follow the adenoma of the vesical cervix (32.4%), the chronic relapsing pyelonephritis (12.9%), and the malignant tumours (7.1%). Many urological forms of diseases appeared combined. In the investigation of the complications without lethal exitus which appeared in 25.1% of all cases with concomitant diabetes the cardiovascular failure is again in the first place, then follow thrombotic diseases, urea-nitrogen disturbances. Peculiarities in conduction and treatment of the diabetes mellitus are shown and a close collaboration between several specialities is considered necessary.
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PMID:[Frequency of diabetes mellitus and nature of treatment in urologic diseases]. 73 75

Emphysematous pyelonephritis is a rare life-threatening infection of the renal parenchyma. It usually affects unilateral kidney and occurs mostly in diabetic patients. It is characterized by the presence of gas within the renal parenchyma and requires prompt diagnosis and early aggressive therapy. Bilateral emphysematous pyelonephritis is even more rare and is associated with high mortality. We describe a case of a 62-year-old diabetic woman who presented with nonketotic hyperosmolar coma and bilateral emphysematous pyelonephritis caused by Klebsiella pneumoniae. Diagnosis of bilateral emphysematous pyelonephritis was confirmed by an abdominal computed tomographic scan and microbiologic studies. Our patient was successfully treated using percutaneous catheter drainage and long-term antibiotic therapy.
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PMID:Bilateral emphysematous pyelonephritis with perirenal abscess cured by conservative therapy. 1085 80

Atypical organ and endometrial changes in 2 female patients under pe rmanent acyclic therapy with Lyndiol are reported. The 1st patient had undergone a bilateral nephrectomy for contracted kidneys due to pyelonephritis and died in uremic coma after extracorporal dialysis, bef ore the renal transplantation could be performed. She had been treated for profuse menorrhagia with 5 mg Lyndiol for 11 weeks. The so-called therapeutic pseudopregnancy found at the postmortem examination was attributed to the unintended accumulation of hormones due to the absence of the renal excretory organs as well as to liver damage from uremia and steroids. Besides the uremic damage, the administered steroids are obviously also responsible for the unusually extensive necroses found in the liver and the adrenal glands. In the 2nd case, permanent (15 months) therapy with Lyndiol was prescribed in order to eliminate meno-metrorhagias in chronic myelosis. Curettages were performed 2, 11, 14, and 21 months after treatment was begun. Besides the known contrary glandular and stroma reaction at the glandular epithelium as sign of its exhaustion, biopsy controls also revealed very extensive regressive chan ges similar to those seen in glandular hyperplasia, and also atypical regenerates. Characteristic features of differentiation from the choriogenic Arias-Stella phenomenon and from incipient carcinoma of the corpus uteri are pointed out.
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PMID:[Atypical organ-oriented effects of so-called ovulation inhibitors following bilateral nephrectomy, as well as unusual endometrial changes during long-term acyclic therapy for chronic myelosis]. 1215 26

Multiple tumors in the liver, kidney, and on the posterior side of the urinary bladder were accidentally found when a diabetic woman visited the hospital. She refused to undergo surgery; therefore, she was only observed for 2 months. Subsequently, she was found unconscious at home and diagnosed with urinary infection, sepsis, and hyperglycemic hyperosmolar non-ketotic coma. The case followed a fulminant course, and she soon died. Postmortem computed tomography revealed emphysematous pyelonephritis (EPN), a rare, life-threatening infection. This case highlights the importance of carefully managing infection in diabetic patients, and it may contribute to clarifying the pathogenesis of EPN.
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PMID:Fulminant emphysematous pyelonephritis (EPN) in a diabetic patient suspected of having multiple tumors. 2104 67

A total of 82 episodes of diabetic ketoacidosis were analysed in 70 adult patients. Population characteristics can be seen in Table 1. It was possible to determine the causes of 74 episodes (Table 2); infections, insulin reduction or suppression and psychic stress included 89 % of these causes. The most frequent infection sites were airway, urinary tract and skin surface. The most important symptoms and signs shown by patients on admission (Table 3) were digestive and those derived from dehydration and acidosis. Figure 2 shows laboratory data on admission: average glycemia, 395 mg %, 90 % with pH values below 7.30; the majority revealed high hematocrit urea and kaliemia values. Unusual treatment performed in the classical way (Figure 3) can be divided into two periods: the first of eapid expansion and insulinization (first three hours) and the second of slow replenishment (4 to 24 hours) consisting of two stages in which the velocity of liquid infusion is diminished while glucose and potassium backing is started. No difference was found between the results of those who received bicarbonate and those who did not (Table 4). Response to treatment is shown in Fig. 4. On pointing out the decrease in kalemia (1.18 mEq/l in the first 6 hours), however, it must be kept in mind that on admission 10 % of the patients were in a state of hypokalemia with less than 3.5 mEq/l. Table 5 shows complications that arose during treatment: hypokalemia, 32 %; hupoglucemia, 11 % and phlebitis, 17 % (catheterized). Five patients, (7 5) died. Four had been admitted in a state of coma with a severe infectious state (bronchopneumonia, acute pyelonephritis, meningo-encephalitis). The analysis of this paper shows the importance of an adequate diabetic education and briefing both for the patients, to be aware of the unleashing factors, and for the physicians, in order to avoid the complications of treatment.
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PMID:[Diabetic ketoacidosis. Revision of 82 episodes]. 2216 95

We present a rare case of emphysematous cystitis associated with an emphysematous pyelonephritis in a diabetic Arab man who was admitted in a confusional state. A 60-year-old man was admitted to the emergency department with confusion and hypogastric mass. The Clinical examination found comatose patient with a mass in the tympanic hypogastric percussion. The pelvic computed tomography (CT) demonstrated intramural gas in the urinary tract, which suggested a diagnosis of emphysematous cystitis and emphysematous pyelitis. The treatment was based on an antibiotics associated with a bladder drainage and diabetes stabilization. The evolution was uneventful. Every diabetic patient with a urinary tract infection who seems to be severely ill should have an abdominal X-ray as a minimal screening tool to detect emphysematous complications. The rarity and the association with an emphysematous pyelitis, which is rarely reported in the literature, are two remarkable characteristics described in this case report.
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PMID:Emphysematous cystitis and emphysematous pyelitis: a clinically misleading association. 2632 3

We report a case of an infected subdural hematoma that occurred 1 year after burr-hole irrigation for chronic subdural hematoma. A 78-year-old woman who had developed left hemiparesis was admitted to our hospital. A computed tomography(CT)scan revealed the presence of a chronic subdural hematoma in the right hemisphere. Her clinical symptoms improved immediately after emergency burr-hole irrigation, which allowed her discharge from the hospital. One year after the initial surgery, she developed an infection of the urinary tract infection, which led to severe pyelonephritis and septic shock. Treatment of the urological symptoms eliminated the systemic inflammation. One month after the urinary infection, the patient was readmitted to the hospital in a comatose state. A CT scan showed regrowth of a residual subdural hematoma surrounded by a thick capsule, causing a midline shift in the brain. An emergency operation for removal of the subdural hematoma by burr-hole irrigation was performed, and pus was drained from the subdural mass. Microbiological cultures of the abscess revealed the presence of Proteus mirabilis. After surgery, the patient was administered an antibiotic treatment for three weeks and she was discharged with no neurological deficits. Cultures of blood from the septic shock as well as from the abscess both revealed the presence of Proteus mirabilis. Therefore, a diagnosis of infected subdural hematoma, which was caused by hematogenous infection, was made. We conclude that attention should be paid to the risk of infection of the hematoma capsule in subdural hematomas.
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PMID:[Infected subdural hematoma having a surgery of chronic subdural hematoma 1 year ago:a case report]. 2567 58

Streptococcus agalactiae is a well-known pathogen during pregnancy and in neonates. Among non-pregnant adults, invasive infection, although rare, is showing increasing frequency, especially in chronically ill, immunosuppressed, or older patients. Although rare, the clinical features of meningeal infection caused by S. agalactiae are similar to other bacterial meningitis. The authors report the case of a middle-aged man previously diagnosed with hypertension, diabetes mellitus, and alcoholic liver cirrhosis, who was admitted at the emergency department with a Glasgow Coma Scale of 11/12, generalized spasticity, bilateral Babinski sign, and hypertension. The clinical outcome was bad, with refractory shock and death within 24 hours of hospitalization. The bacteriological work-up isolated S. agalactiae in the cerebral spinal fluid (CSF), blood, and urine. An autopsy revealed meningoencephalitis, acute myocardial infarction, and pyelonephritis due to septic emboli. The authors point out the atypical CSF findings, the rapid fatal outcome, and the importance of including this pathogen among the etiologic possibilities of invasive infections in this group of patients.
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PMID:Streptococcus agalactiae septicemia in a patient with diabetes and hepatic cirrhosis. 2689 44

Prickly heat is a benign cutaneous manifestation due to the obstruction of the sweat ducts following excessive exposure to heat, humidity or hyperthermia. We report the case of a 70-year old diabetic female patient treated with insulin, hospitalized in the Intensive Care Unit due to acidocetosic coma secondary to pyelonephritis. The patient had diffuse clear vesicular lesions spread all over the body,(a) firm to palpation, on a healthy skin, suggesting miliaria crystallina. Miliaria crystallina is a benign cutaneous manifestation due to sweat retention secondary to obstruction of the sweat ducts. It is possible to distinguish between miliaria crystallina due to the obstruction in the stratum corneum, miliaria rubra due to the obstruction within the malpighian stratum and miliaria profunda due to an obstrusction in or below the dermoepidermal junction, depending on the level of obstruction. Miliaria crystallina heals spontaneously in a few hours giving rise to a desquamation, as occurred in our patient after regression of febrile syndrome.
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PMID:[Widespread miliaria crystallina: about a case]. 3034 53


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