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

A case of emphysematous pyelonephritis, xanthogranulomatous pyelonephritis histologically, is reported. A 49-year-old female patient was referred to our department from the department of internal medicine because abdominal ultrasonography demonstrated left renal swelling with gas echo. Computed tomographic scan showed much emphysema in the left kidney. Although aggressive treatment with broad spectrum antibiotics and immunoglobulin had been performed, subfever and left lumbago continued. Thereafter, she underwent left nephrectomy, and histological findings revealed xanthogranulomatous pyelonephritis. In the Japanese literature 27 cases of emphysematous pyelonephritis have been reported. Many cases are in middle-aged females and 85% of these cases complicated with diabetes mellitus. E. coli and Klebsiella was the main causative organism. The mortality of this disease was 26%. This report is the first case combined with xanthogranulomatous pyelonephritis in Japan. We recommend adequate chemotherapy and timely surgical treatment for good results.
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PMID:[A case of emphysematous pyelonephritis combined with xanthogranulomatous pyelonephritis]. 273 41

Analysis of data from the Canadian National Renal Failure Register indicates that Canadian Natives are at much higher risk for end-stage renal disease (ESRD) than the Canadian population in general. Using two population estimates for the total Native population, the age-standardized incidence rate of newly registered ESRD cases between 1981 and 1986 among Natives was at least 2.5 times (and may be as high as four times) the national rate. Natives were particularly at higher risk for ESRD to diabetes, glomerulonephritis, and pyelonephritis, whereas for the other causes the risk was no different from that of other Canadians. As technologically sophisticated treatment facilities are only available in major urban centers, Native ESRD patients and their families living in remote areas of Canada are faced with major psychosocial disruptions of relocation.
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PMID:Excessive burden of end-state renal disease among Canadian Indians: a national survey. 278 48

150 patients dying from renal cell carcinoma are studied in order to reveal the background disease, incidence and character of the nephrosclerosis and the possible morphogenetic link between nephrosclerosis and carcinoma. Renal cell carcinoma is found to develop in 82.7% of cases in the kidneys with signs of nephrosclerosis. The diffuse nephrosclerosis developing in connection with the hypertension disease, atherosclerosis, diabetes mellitus, chronic pyelonephritis, nephrolithiasis is the most important. Proliferation of the canaliculi epithelium with the appearance of undifferentiated cells are regularly found in the nephrosclerotic areas. The disturbance of the epithelium differentiation is followed by the development of dysplasia the phenotypical variants of which are similar to those of renal cell carcinoma. Adenomas are found in 11.3% of cases of renal cell carcinoma which may originate from the adenomas developing against the background of nephrosclerosis.
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PMID:[Background and precancerous processes in renal cell carcinoma]. 280 41

Glomerulonephritis patients transplanted with cadaver kidneys had a significantly higher one-year graft survival when immunosuppressed with cyclosporin rather than standard therapy (80% versus 59%, p less than 10(-5]. For nephrosclerosis patients the corresponding rates were 70% and 59% (p greater than 0.05); and in those with antecedent diabetes mellitus, polycystic kidney, and pyelonephritis the differences were negligible. In glomerulonephritis patients, but not in the other groups, cyclosporin was additive to the effect of transfusions and of HLA-A, B and HLA-Dr matching.
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PMID:Preferential effectiveness of cyclosporin in patients receiving kidney transplants after glomerulonephritis. 285 55

In a consecutive material of 652 E. coli bacteremia 70 episodes (11%) were found in 64 patients with diabetes mellitus. 10 patients had insulin-dependent and 54 had non-insulin-dependent diabetes. The E. coli strains were tested for adhesive properties as mediated by P-fimbriae, a virulence factor in human urinary tract infections. Half of the strains were P-fimbriated with a higher occurrence in women (26/42, 62%) than in men (9/27, 33%). Diabetic patients with a positive urine culture had a higher incidence of P-fimbriated E. coli strains (27/37, 73%) in blood culture than patients with negative or no urine culture taken (8/32, 25%). Furthermore, patients without compromising factors, regardless of their diabetes mellitus, had a higher incidence of P-fimbriated E. coli strains (19/29, 66%) than those with malignancies and other debilitating diseases (6/22, 27%). The high incidence of P-fimbriated E. coli strains in the non-compromised patients may depend on the ability of such bacteria to invade the urinary tract and cause acute pyelonephritis, which often precedes E. coli bacteremia. A lower incidence of P-fimbriated E. coli strains was found in patients with proteinuria prior to the bacteremic episode (10/31, 32%), compared to those without proteinuria (25/35, 71%). No correlation was noted between P-fimbriation and duration of diabetes or serum creatinine. The low incidence of P-fimbriated E. coli strains in patients with proteinuria indicates that nephropathy, or some concurrent complication, predisposes the diabetic patient to bacteremia with low virulent, non-P-fimbriated E. coli.
Diabetes Res 1987 Oct
PMID:Bacteremia with P-fimbriated Escherichia coli in diabetic patients: correlation between proteinuria and non-P-fimbriated strains. 289 4

A study of the clinical presentation and conceivable causes of chronic renal failure (CRF) in 61 Sudanese patients in Khartoum is presented. The clinical features involved almost all the systems, however, gastrointestinal and cardiovascular signs and symptoms predominated. The causes of chronic renal failure in Sudan and Sweden are also studied for comparison. The causes of CRF in Sudan are chronic glomerulonephritis, obstructive nephropathy (stone disease), hypertension and diabetes mellitus in that order. The main causes of CRF in Sweden are chronic glomerulonephritis, diabetes mellitus and chronic pyelonephritis. Of the 61 Sudanese patients 16 have kidney transplants, only one in Sudan, three patients are on regular hemodialysis, nine patients are on intermittent peritoneal dialysis, 16 are on conservative treatment and 17 died during the course of treatment.
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PMID:Chronic renal failure in Khartoum, Sudan. 303 72

The traditional criterion of 10(5) colony-forming units (CFU) per milliliter of urine to diagnose urinary tract infection was based on studies of pregnant and nonpregnant women with asymptomatic bacteriuria or acute pyelonephritis. Recent studies of symptomatic women revealed that urine cultures in approximately one third of those with confirmed urinary tract infections grew only 10(2) to 10(4) CFU/mL. The major causes of acute dysuria among such women are urinary tract infection, sexually transmitted disease, and vaginitis. In most instances, it is possible to make the diagnosis based on clinical features. The major features of urinary tract infection are internal dysuria; frequency, urgency, and voiding of small volumes; abrupt onset; suprapubic pain; presence of pyuria. Presence of hematuria which occurs in about 50 percent of patients strongly suggests bacterial cystitis. Three to seven days of empiric antimicrobial therapy is indicated for these patients, with selection of a first-line antimicrobial agent that offers efficacy against Escherichia coli or Staphylococcus saprophyticus; reasonable cost; few side effects. Ampicillin is not recommended. Indications for culture include uncertain clinical features; history of previous infection within the past three weeks; duration of symptoms of more than seven days; recent hospitalization or catheterization; pregnancy; diabetes. To maximize the sensitivity and specificity of the urine culture in acutely symptomatic women, it is necessary to request the laboratory to report 10(2) to 10(4) CFU/mL.
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PMID:Protocol for diagnosis of urinary tract infection: reconsidering the criterion for significant bacteriuria. 304 81

Proteus mirabilis was the predominant cause of acute diabetes-associated pyelonephritis occurring spontaneously in male MM mice until they were segregated in a new environment. Thereafter Pasteurella pneumotropica and Streptococcus faecalis emerged collectively as the most common causal organisms, the pyelonephritis became more chronic and Proteus mirabilis isolates from faeces and urine produced atypical non-swarming colonies on blood agar plates. This did not account for the reduced pathogenicity of Proteus mirabilis; when MM males were returned to the original environment the pyelonephritis again became acute but was associated with the atypical type of Proteus mirabilis although the normal type was abundant in the environment. The MM mice were Caesarean-derived and cross-fostered shortly before their transfer to the second environment, which probably accounts for their changed microbial status, but the reason for the emergence of the atypical type of Proteus mirabilis is not understood. The acute nature of the male MM pyelonephritis when caused by Proteus mirabilis parallels the situation described in other animals and humans.
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PMID:A shift from acute to chronic spontaneous pyelonephritis in male MM mice associated with a change in the causal micro-organisms. 312 33

Emphysematous pyelonephritis is an acute infectious process mostly associated with diabetes and obstruction. It is a life-threatening illness and treatment generally involves antibiotic therapy, surgical drainage and nephrectomy. The prognosis is poor regardless of therapy. Herein, we present a case with pneumocystitis. To our knowledge, there have been 54 cases previously reported. There is no doubt that emphysematous pyelonephritis with pneumocystitis as in our case is less frequent.
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PMID:Emphysematous pyelonephritis with pneumocystitis. 320 48

We report the case of a 59-year-old diabetic woman with emphysematous pyelonephritis. The patient presented with nausea, vomiting, and right flank pain of three days duration. The diagnosis was established by a plain abdominal radiograph in the emergency department. Aggressive rehydration, control of diabetes, broad-spectrum antibiotic therapy, and early right nephrectomy resulted in rapid clinical improvement. Emphysematous pyelonephritis is rare and often fatal. Survival depends on early diagnosis and aggressive combined medical and surgical management.
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PMID:Emphysematous pyelonephritis: an emergency indication for the plain abdominal radiograph. 328 24


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