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

Renal scars have been thought to occur only in later stages of chronic pyelonephritis. In our experimental pyelonephritis model, bacteria with mannose-sensitive (MS) pili on its surface promoted renal scarring when inoculated into renal parenchyma. Pretreatment with recombinant human granulocyte-colony-stimulating factor (rhGCSF) inhibited the renal scarring which followed inoculation with MS-piliated bacteria, whereas posttreatment at an early stage of infection had no effect on renal scarring. These findings suggest that rhGCSF may be useful for the prevention of infection without increasing the tissue damage to the renal parenchyma which leads to the renal scarring. Even when rhGCSF is used for treatment of kidney infection, it does not promote increased renal scarring through the increased invasion of leukocytes at the inflammatory site.
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PMID:Effect of recombinant human granulocyte-colony-stimulating factor on renal scarring following infection with MS-piliated bacteria. 768 31

528 pregnancies of primiparous girls 13-17 years old who gave birth during 1988-90 at the obstetrical ward of the city of Pleven, Bulgaria, were evaluated. The pregnancy outcome and neonatal results were compared with those of 100 controls. These 528 births amounted to 5.48% of a total of 9635 births at the clinic. These girls were of low socioeconomic status, 14.2% were illiterate or had low educational attainment, and 56.42% were of Gypsy origin, without skills, and from rural areas. Only 32.89% of the Bulgarian girls had an official marriage license. Anemia was found in 13.64%, kidney infection (without symptoms of bacteriuria, pyelonephritis) in 6.44%, preeclampsia in 2.46%, and eclampsia in 0.76%. The most frequent occurrence was premature rupture of the membrane (9.85%). Term deliveries numbered 433 and preterm deliveries 95. There was a statistically significant difference between the two groups with respect to term and preterm deliveries (p 0.01). Dystocia amounted to 2.8% and instrumental delivery to 1.70% among these adolescent girls. The rate of premature delivery reached 17.99%, and cesarean section was performed in 5.44%. There was a significant difference between the two groups with respect to vaginal delivery (p 0.01) and cesarean section (p 0.01). 44% of 16-year old girls underwent cesarean section; and there was a significant difference in the rate of cesarean section between 14-year-old and 17-year-old girls (p 0.05) as well as between 16-year-old and 17-year-old girls (p 0.01). 71.95% of newborns had a birth weight of less than 3000 g. There was also a significant difference between the groups with regard to term and prematurely born neonates (p or = 0.01). Intrauterine growth retardation reached 2.46% because of the inadequate uterine size of girls 13-14 years old, insufficient weight gain during pregnancy (under 9 kg), and complications (preeclampsia and eclampsia). The rate of stillbirths was 7.63%, attributed to prematurity and malformation of the fetus. Maternal mortality reached 1.89% owing to pregnancy complications (eclampsia) among 17-year old girls because of low socioeconomic status and complete lack of prenatal care.
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PMID:[Pregnancy and labor in young girls]. 779 32

Nonobstructive acute pyelonephritis in humans is most often caused by P-fimbriated Escherichia coli. P-fimbriae are heteropolymeric fibers carrying a Gal(alpha 1-4)Gal-specific PapG adhesin at its distal end. The pyelonephritic strain DS17 expresses P-fimbriae from a single gene cluster. A mutant strain, DS17-8, which expresses P-fimbriae tacking the PapG adhesin, was constructed by allelic replacement introducing a 1-bp deletion early in the papG gene. In cynomolgus monkeys, DS17 and DS17-8 were equally able to cause bladder infection, whereas only the wild-type strain DS17 could cause pyelonephritis as monitored by bacteriological, functional, and histopathological criteria. Since DS17, but not DS17-8, adheres to renal tissue, these data underscore the critical role of microbial adherence to host tissues in infectious disease and strongly suggest that the PapG tip adhesin of P-fimbriae is essential in the pathogenesis of human kidney infection.
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PMID:The Gal(alpha 1-4)Gal-specific tip adhesin of Escherichia coli P-fimbriae is needed for pyelonephritis to occur in the normal urinary tract. 799 52

There is no general agreement on which terms to use to report abnormalities on imaging studies in patients with kidney infection. The Society of Uroradiology recommends a simplified nomenclature that is based on the traditional and widely understood term acute pyelonephritis. To provide a framework for the simplified terminology, the authors review the relevant pathophysiology with its imaging correlates and offer a historic perspective on the terminology issues.
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PMID:Acute pyelonephritis: can we agree on terminology? 802 84

Pyelonephritis is a frequent infection of variable severity. Mortality is low since the era of antibiotics. Emphysematous pyelonephritis is however a rare but life threatening form of kidney infection, which affect more frequently diabetic subjects, characterized by gas producing bacteria. These gaseous lesions can be localized in the renal parenchyma or in the perirenal or retroperitoneal space. Diagnosis became easier with the advent of CT scan. Treatment usually requires surgery and antibiotics. We report a case of emphysematous pyelonephritis in a diabetic patient. The CT scan strongly suggested the diagnosis which was confirmed per-operatively. Proteus mirabilis is exceptionally described in emphysematous pyelonephritis.
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PMID:[Emphysematous pyelonephritis]. 985 41

A model of ascending unobstructed urinary tract infection (UTI) in mice was developed to study the significance of the antibiotic concentration in urine, serum, and kidney tissue for efficacy of treatment of UTI in general and pyelonephritis in particular. Outbred Ssc-CF1 female mice were used throughout the study, and Escherichia coli was used as the pathogen. The virulence of 11 uropathogenic E. coli isolates and 1 nonpathogenic laboratory E. coli strain was examined. Strain C175-94 achieved the highest counts in the kidneys, and this strain was subsequently used as the infecting organism. The model gave reproducible bladder infections, i.e., bacteria were recovered from 22 of 23 control mice after 3 days, and histological examination of kidney tissue showed that of 14 infected kidneys, 7 (50%) showed major histological changes, whereas 3 of 36 uninfected kidneys showed major histological changes (P = 0.018). Once the model was established, the efficacies of different doses of cefuroxime and gentamicin, corresponding to active concentrations in urine only or in urine, serum, and kidney tissue simultaneously, were examined. All cefuroxime doses resulted in significantly lower counts in urine than control treatments, but the dose which produced concentrations of cefuroxime only in urine and not in serum or kidney tissue had no effect on kidney infection. Even low doses of gentamicin (0.05 mg/mouse) resulted in concentrations in renal tissue for prolonged times due to accumulation. All gentamicin doses had a significant effect (compared to the effect of the control treatment) on bacterial counts in urine and kidneys. The antibiotic effect on bacterial counts in bladders was negligible for unknown reasons. Use of the mouse UTI model is feasible for study of the effect of an antibiotic in the urinary system, although the missing antibacterial effect in the bladder needs further evaluation.
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PMID:Development of a long-term ascending urinary tract infection mouse model for antibiotic treatment studies. 1060 38

The past several years have brought marked changes in our understanding of the consequences of urinary tract infections (UTIs). Studies of infants with intrauterine dilatation of the urinary tract show that many children previously thought to have incurred kidney damage after an infection actually have congenital renal damage. The importance of vesicoureteric reflux (VUR) in the pathogenesis of acute pyelonephritis has been downgraded with the recognition of the frequency with which kidney infection occurs in the absence of VUR. Some infants with intrauterine VUR and no history of UTI have impaired kidney function or hypertension secondary to renal hypoplasia or dysplasia.
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PMID:Long-term consequences of urinary tract infections. 1076 61

To assess the role of complement in renal infection, we studied a model of Escherichia coli-induced pyelonephritis in mice deficient in complement components C3 and C4. Renal infection occurred less frequently in C3- and C4-deficient mice compared with wild-type mice. In vitro, renal epithelial cells internalized fewer bacteria in the absence of C3 or in the presence of blockade of C3 bound to the bacteria. Moreover, upregulation of epithelial C3 production by stimulation with lipopolysaccharide enhanced bacterial internalization. Here we provide evidence that uropathogenic E. coli might use host C3 to invade the renal epithelium and that local complement production is sufficient for the bacteria to achieve this effect.
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PMID:Epithelial secretion of C3 promotes colonization of the upper urinary tract by Escherichia coli. 1143 44

Renal infection, including acute and chronic pyelonephritis, focal bacterial nephritis, renal and perinephric abscess, pyonephrosis and others, represents a spectrum of interrelated conditions. In recent years, computed tomography, ultrasound, nuclear scintigraphy, excretory urography (IVP) and magnetic resonance imaging have offered varying degrees of utility in evaluating renal infection. Although imaging in acute pyelonephritis has been extensively studied, this condition is a rare initial presentation as a renal cystic feature. This investigation presents a case of acute pyelonephritis, with an atypical initial imaging manifestation in renal cystic feature, which became a heterogeneous mass during follow up, and disappeared after treatment. Two conclusions can be drawn: first, a renal cystic lesion may be an initial presentation of acute pyelonephritis; secondly, the abnormalities of the ultrasonography imaging study of renal pyelonephritis persisted and progressed despite the improvement in clinical symptoms and laboratory findings, and displayed complete resolution of imaging abnormalities several months later.
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PMID:Atypical initial manifestation of acute pyelonephritis in continuous image study: renal cystic feature. 1221 27

Emphysematous pyelonephritis is a necrotizing kidney infection characterized by the presence of gas in renal parenchyma, collecting system or perinephric tissue. This rare affection occurs almost exclusively in patients with diabetes mellitus and is due to non-anaerobic gas-producing bacteria. This life-threatening condition leads to septic shock and multiple organ failure. Diagnosis is suspected when a pyelonephritis does not respond to correct treatment, especially with altered vital signs or a diabetic patient. Computed tomography scan permits visualization of the gas and a radiologic classification with a prognostic value. Current treatment modalities are based upon repeated clinical and scanographic evaluations. In addition to systematic antibiotic therapy, percutaneous drainage is probably the first therapeutic stage in the majority of cases, but should not delay emergent rescue nephrectomy if necessary.
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PMID:[Emphysematous pyelonephritis: diagnosis and treatment]. 1600 3


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