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

This article reviewed some of the fundamental concepts in renal inflammatory disease. The difficulties in present terminology were reviewed and our approach discussed. The pathological underpinning of the acute-subacute infections were contrasted with those seen in the granulomatous diseases. The importance of CT in separating emphysematous pyelonephritis from emphysematous pyelitis and perinephric emphysema was stressed. Although ultrasound has been used in the past and is still of value in select situations, we prefer CT for assessment of renal infection. CT examinations show whether the disease is focal or diffuse, whether air is present, whether there is perinephric or pararenal extension, whether an abscess is present, and when the ideal time is for intervention. In severe renal infection in the adult, CT has shown the development of renal scars, perinephric extension, and the spontaneous drainage of Staphylococcus abscesses into nearby calyces.
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PMID:Upper urinary tract infection: the current role of CT, ultrasound, and MRI. 189 94

Renal emphysema is an important clinical entity that is not addressed frequently in the medical literature. The affected patients may have gas within the renal parenchyma, emphysematous pyelonephritis, or confined to the collecting system, emphysematous pyelitis. Two patients that illustrate the spectrum of this entity are described. The literature has been reviewed to determine the clinical features of each disorder and to provide a schema for diagnosis and management. Emphysematous pyelonephritis is seen primarily in diabetic patients, whereas emphysematous pyelitis is recognized most often in association with urinary tract obstruction. The diagnosis is made radiographically by demonstrating renal gas on plain abdominal roentgenography or intravenous pyelography. Location and extent of renal gas are best evaluated by computed tomographic scanning. Intraparenchymal gas usually requires nephrectomy, whereas successful therapy of gas limited to the collecting system involves medical management, with a drainage procedure when obstruction coexists.
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PMID:Spectrum of gas within the kidney. Emphysematous pyelonephritis and emphysematous pyelitis. 330 Mar 21

Ureterocolonic anastomosis was evaluated in 13 clinically normal dogs. Urinary continence was maintained after surgery, and the procedure was completed without technique errors in all but 2 dogs. Three dogs died within 5 weeks (2 of undetermined causes and 1 of aspiration pneumonia and neurologic disease), and 1 dog was euthanatized 4 months after surgery because of neurologic signs. Two healthy dogs were euthanatized 3 months after surgery for light microscopic evaluation of their kidneys. Five dogs were euthanatized 6 months after surgery for light microscopic evaluation of their kidneys. Gastrointestinal and neurologic disturbances developed in 4 dogs at various postoperative intervals. Plasma ammonia concentration measured in 2 dogs with neurologic signs was increased. Plasma ammonia concentration measured in 5 dogs without neurologic signs was within normal limits. All 5 dogs, in which metabolic acidosis was diagnosed, had high normal or above normal serum chloride concentration. Serum urea nitrogen values were increased after surgery because of colonic absorption of urea. Serum creatinine concentration was increased in 1 dog 6 months after surgery. Individual kidney glomerular filtration rate was reduced in 38% (3/8) of the kidneys from 4 other dogs at 6 months after surgery. Of 5 dogs euthanatized at 3 to 4 months after surgery, 4 had bilateral pyelitis, and 1 had unilateral pyelonephritis. Six months after surgery, pyelonephritis was diagnosed in 40% (4/10) of the kidneys from 5 dogs. The ureterocolonic anastomosis procedure is a salvage procedure that should allow complete cystectomy. However, variable degrees of metabolic acidosis, hyperammonemia, and neurologic disease may result.
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PMID:Ureterocolonic anastomosis in clinically normal dogs. 342 37

Epidemiological studies suggest that urinary tract infection is an important risk factor in the development of bladder cancer. Chronic urinary tract infection in rats is associated with urothelial hyperplasia and papillomatosis. In the Sprague-Dawley strain, exposure to the 5-nitrofuran, N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide (FANFT), is associated in particular with the development of renal pelvic tumors. The present study was designed to evaluate whether chronic urinary tract infection could enhance tumor development in FANFT-induced urinary tract carcinogenesis. One hundred forty-four female Sprague-Dawley rats were divided into the following groups. Group 1 received 0.2% FANFT in the diet for 7 wk followed by control diet. Group 2 received 0.2% FANFT in the diet for 7 wk followed by control diet. One wk after completion of FANFT administration, the suspension of 0.5 ml of Escherichia coli (06K13H1) was injected into the bladder through the urethra. Group 3 received 0.2% FANFT in the diet for 7 wk followed by control diet. One wk after completion of FANFT administration, a suspension of heat-killed E. coli (06K13H1) was injected into the bladder through the urethra. Group 4 received a suspension of 0.5 ml of E. coli (06K13H1) through the urethra and received control diet throughout the experiment. Group 5 was fed control diet only. The experiment continued for 104 wk. A significantly higher number of urinary tract tumors, particularly of the renal pelvis, was recorded in Group 2 compared to Groups 1, 3, 4, and 5. The majority of the rats in Groups 2 and 4 had morphological signs of urinary tract infections, particularly pyelitis and/or pyelonephritis. Thus, a single injection of E. coli (06K13H1) into the bladder results in an enhancement of FANFT-induced urinary tract carcinogenesis in the Sprague-Dawley rat, especially for renal pelvic tumors. The formation of dimethylnitrosamine or other nitroso compounds from nitrates in the urine or increased cell proliferation due to chronic inflammation or both may be important pathogenetic factors in the tumor development.
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PMID:Enhancement of N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide-induced carcinogenesis by urinary tract infection in rats. 353 25

Emphysematous renal infection is a severe, rare complication of urinary tract infection associated with gas production, which frequently causes renal destruction and has a high mortality rate. It is termed emphysematous pyelitis when gas is confined to the collecting system, or emphysematous pyelonephritis if it also involves the parenchyma with or without the perirenal space. Only 7 cases of perirenal emphysema have been described previously; all were in diabetics. Here we present a rare case of gas-producing renal infection in the collecting system and perirenal tissues, in a nondiabetic patient, and discuss the management of the various types of emphysematous renal infections.
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PMID:Emphysematous renal and perirenal infection in nondiabetic patient. 403 53

Unilateral hydronephrosis was induced by temporary ligature of the left ureter in 29 rabbits. In 21 animals so treated, chronic pyelonephritis was simultaneously induced by intravenous application of a suspension of E. coli. Histologic examination of renal pelvic epithelia in animals killed four weeks after the surgical intervention, revealed the following features: 1. Simple hyperplasia of urothelium in 12 cases, 2. atypical hyperplasia - (dysplasia) of urothelium in 10 cases, 3. v. Brunn's nests in 20 renal pelvises; 11 cases of cystic pyelitis, all combined with Brunn's nests, 4. metaplastic transformation of visceral mono- or bilayered epithelium into multi-layered urothelium-like structures in 19 renal pelvises. These changes are observed almost exclusively in the left renal pelvis of animals subjected to temporary ureteral ligature. Atypical urothelial hyperplasia is found only together with chronic pyelonephritis. Hyperplastic and dysplastic epithelial changes in the renal pelvis, the formation of Brunn's nests, and cystic pyelitis are interpreted as sequelae of postrenal obstruction or concomitant chronic inflammation.
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PMID:Epithelial abnormalities in the renal pelvis in experimental hydronephrosis and pyelonephritis. 634 54

Histological lesions were observed in the kidneys of 77 (32.5%) of 237 rabbits which were either found dead or were killed because they were unwell, and in 19 (25%) of 75 apparently healthy adult rabbits. Lesions associated with an infectious process such as renal abscesses, staphylococcal nephritis, pyelonephritis and pyelitis were the principal finding in rabbits up to 5 months of age, while renal fibrosis, with or without dystrophic calcification, was the most common lesion observed in rabbits aged over 10 months. Spontaneous amyloidosis was seen in 2 rabbits.
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PMID:Kidney disease in the rabbit: a histological survey. 728 77

Bacterial UTIs are a common problem in patients with diabetes mellitus. Bacteriuria is more common in diabetic women than in non-diabetics owing to a combination of host and local risk factors. Upper tract disease is also more common in this group. Diabetics are at higher risk for intrarenal abscess, with a spectrum of disease ranging from acute focal bacterial pyelonephritis to renal corticomedullary abscess to the renal carbuncle. A number of uncommon complicated UTIs, such as emphysematous pyelonephritis and emphysematous pyelitis, occur more frequently in diabetics. Because of the frequency and severity of UTI in diabetics, prompt diagnosis and early therapy is warranted.
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PMID:Bacterial urinary tract infections in diabetes. 776 19

The paper is concerned with ecological aspects of uronephrology. The epidemiological survey entering 1249 rural citizens revealed that the frequency of infectious inflammatory lesions of the kidneys is higher in subjects exposed to pesticides (7.9-13.4% against 1.5% in the controls). The experiments on 82 rabbits confirmed the relation of the renal infectious inflammation severity and incidence to exposure to chemicals used in agriculture. Basing on the analysis of 301 cases of acute renal infection, the authors came to distinguish 4 forms of the disease: pyelitis, pyelonephritis, nephropyelitis and purulent nephritis. The authors emphasize the urgent need in the regions of active pesticide application of taking prophylactic measures to reduce the contact with the toxic compounds, to actively detect and treat urinary infection including antidotes.
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PMID:[The characteristics of acute infectious-inflammatory kidney diseases in pesticide exposure]. 801 96

We evaluated the pathogenic role of Corynebacterium urealyticum in the development of encrusted pyelitis (EP) and encrusted cystitis (EC), and their clinical consequences in renal transplant recipients. During a 4-year period, we studied seven renal transplant recipients with EP and two with EC. The records of 320 other renal transplant patients studied during the same period were used as a control group. C urealyticum (> or = 10(5) CFU/ml) was isolated from 4 patients with EP (urine 3, blood 1) and from 1 patient with EC (urine). Alkaline urines with struvite crystals, microscopic hematuria, and sterile conventional urine cultures were present in all our cases. All the patients with EP developed obstructive uropathy with deterioration of the renal function and pyelonephritis (4 patients) or renal abscesses (3 patients). Chronic urinary discomfort and macroscopic hematuria were present in the 2 patients with EC. Long-term vesical and ureteral catheterization were considered the most important risk factors for the development of EC and EP, respectively. Vancomycin was successfully used in 5 cases, but all the patients required a derivative procedure or a surgical resection of the incrustations to improve. We conclude that EP and EC should be investigated in renal transplant patients who develop pyelonephritis, obstructive uropathy, or chronic urinary symptoms. EP and EC could lead to the loss of their grafts. C urealyticum appears to have a pathogenic role in these entities.
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PMID:Encrusted pyelitis and cystitis by Corynebacterium urealyticum (CDC group D2): a new and threatening complication following renal transplant. 821 58


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