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

Pyelitis with acute and chronic pyelonephritis and also primary chronic pyelitis were easily initiated in female rats by a single non-traumatic retrograde infusion of bacteria into the urinary tract. The virulence of the bacterial species and the time of observation were related to the type and extent of lesions, but pyelitis regardless of the virulence appeared to be an important factor. The apex and fornix of the renal pelvic lumen were anatomic sites of persistent pyelitis which permitted local proliferation of bacteria for long periods. Cortical and medullary lesions were anatomically related to these areas of underlying pyelitis. Spread of infection followed a pattern of contiguity rather than ascending tubular infection. The experimental model has many of the features of chronic urinary infections in man and suggests that pyelitis is an important factor in the pathogenesis of chronic pyelonephritis initiated by retrograde infection.
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PMID:Pyelitis, an important factor in the pathogenesis of retrograde pyelonephritis. 1368 29

We report two cases of emphysematous pyelonephritis in diabetic patients. The first suffered from emphysematous pyelonephritis and emergency nephrectomy was performed. The second patient suffered from emphysematous pyelitis and was successfully treated by nephrostomy. We present a comprehensive review of the literature on emphysematous pyelonephritis and discuss the indications and the results of treatments of this rare and severe infection.
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PMID:[Management of the emphysematous pyelonephritis]. 1459 17

Anaerobes have been involved in many different types of urinary tract infection. This review describes the microbiology, diagnosis and management of urinary tract and genito-urinary suppurative infections caused by anaerobic bacteria. The types of infections of the urinary tract in which anaerobes have been involved include para- or periurethral cellulitis or abscess, acute and chronic urethritis, cystitis, acute and chronic prostatitis, prostatic and scrotal abscesses, periprostatic phlegmon, ureteritis, periureteritis, pyelitis, pyelonephritis, renal abscess, scrotal gangrene, metastatic renal infection pyonephrosis, perinephric abscess, retroperitoneal abscess and other infections. The anaerobes recovered in these studies were Gram-negative bacilli (including Bacteroides fragilis and pigmented Prevotella and Porphyromonas sp.), Clostridium sp., anaerobic Gram-positive cocci and Actinomyces sp. In many cases, they were recovered mixed with coliforms or streptococci. The recovery of anaerobes requires the administration of antimicrobial therapy that is effective against these organisms. These antimicrobials include metronidazole, chloramphenicol, clindamycin, a carbapenem, cefoxitin and the combination of a penicillin and a beta-lactamase inhibitor. Percutaneous drainage, open surgical drainage or nephectomy might be indicated for abscesses.
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PMID:Urinary tract and genito-urinary suppurative infections due to anaerobic bacteria. 1500 60

Interfering Escherichia coli attachment to the urinary tract, using P-fimbriation inhibitors, can prevent pyelonephritis. Clofibric and ethacrynic acids are organic compounds structurally related, but with different pharmacological uses. These agents are potentially active in the urinary tract due to its elimination in an unaltered form by the renal route. This study described a pyelonephritogenic E. coli strain, grown in the presence of sub-inhibitory concentrations of clofibric or ethacrynic acids (0.1 and 1 mM, respectively), which exhibits inhibition of P1 erythrocytes agglutination and a drastic decrease in fimbriation, using electron microscopy and quantitative analyses of superficial proteins (decrease to a 17-25% in comparison with the control). In vivo assays were performed using ascending urinary tract infection in mice. The treatment with therapeutic doses of the drugs, administered 2 days before the bacterial challenge and daily until the end of the experiment (22 days), abolished renal infection after 7-10 days of drug exposure. Within this period clofibric acid did not produce adverse effects on the renal parenchyma. However, ethacrynic acid caused pyelitis and tubular cellular desquamation. These results suggested that clofibric acid might be useful in the short-term prophylaxis of urinary tract infection.
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PMID:Clofibric and ethacrynic acids prevent experimental pyelonephritis by Escherichia coli in mice. 1547 45

Emphysematous pyelonephritis (EP) is a life threatening condition of acute necrotising renal parenchymal infection that encompasses a much wider spectrum of complicated urinary tract infections such as renal abscesses, emphysematous pyelitis, pyelonephritis, acute renal papillary necrosis, and sepsis. We report an unusual case of adenocarcinoma bladder in a middle aged nondiabetic patient, presenting with EP. Emphysematous pyelonephritis was the initial symptom in this case with an underlying carcinoma of the bladder. The role of imaging is prime in management of such cases, if an early diagnosis is to be made and a potentially devastating outcome is to be avoided. The literature regarding EP has been reviewed and discussed. The goals of managing EP should be (1) early institution of parenteral antibiotics and a (2) a staged nephrectomy (preceded by a temporary percutaneous drainage particularly with antibiotic resistant septicemia) so as to maximize survival rather than proceeding directly to emergency nephrectomy.
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PMID:Emphysematous pyelonephritis: a consequence of adenocarcinoma of urinary bladder in a nondiabetic patient. 1638 79

Corynebacterium urealyticum, formerly known as coryneform CDC group D2, was first recognized to be involved in human infections 30 years ago. It is a slow-growing, lipophilic, asaccharolytic and usually multidrug-resistant organism with potent urease activity. Its cell wall peptidoglycan, menaquinone, mycolic and cellular fatty acid composition is consistent with that of the genus Corynebacterium. DNA-DNA hybridization studies and 16S rDNA sequencing analysis have been used to determine the degree of relatedness of C. urealyticum to other corynebacterial species. The genome of the type strain consists of a circular chromosome with a size of 2 369 219 bp and a mean G + C content of 64.2%, and analysis of its genome explains the bacterium's lifestyle. C. urealyticum is a common skin colonizer of hospitalized elderly individuals who are receiving broad-spectrum antibiotics. It is an opportunistic pathogen causing mainly acute cystitis, pyelonephritis, encrusted cystitis, and encrusted pyelitis. More infrequently, it causes other infections, but mainly in patients with urological diseases. Infections are more common in males than in females, and treatment requires administration of antibiotics active against the organism in vitro, mainly glycopeptides, as well as surgical intervention, the latter mostly in cases of chronic infection. Mortality directly associated with infection by this organism is not frequent, but encrusted pyelitis in kidney-recipient patients may cause graft loss. The outcome of infection by this organism is reasonably good if the microbiological diagnosis is made and patients are treated appropriately.
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PMID:Microbiological and clinical features of Corynebacterium urealyticum: urinary tract stones and genomics as the Rosetta Stone. 1855 35

Renal emphysema is a rare, fulminant, suppurative infection of pelvicaliceal system, renal parenchyma, perinephric tissues, and retroperitoneum. It is characterized by formation of gas. Invariably this condition is associated with diabetes mellitus and carries high mortality (40-90%). Renal emphysema can be classified into two distinct clinical entities: emphysematous pyelitis and emphysematous pyelonephritis. This classification has important prognostic and therapeutic implications. Herein we describe the computed tomographic findings in five unilateral cases of renal emphysema (two cases of emphysematous pyelitis and three cases of emphysematous pyelonephritis) in five insulin-dependent diabetic patients.
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PMID:Renal emphysema in diabetic patients: CT evaluation. 1983 84

Experimental infiltration of the intravesical ureter of the normal bladder in the living, anesthetized animal with magnesium sulfate or physiological salt solution caused a reflux of urine into the ureter in 6 out of 18 guinea pigs (33 per cent); in 22 out of 27 rabbits (81 per cent), and in 14 out of 17 dogs (82 per cent). The vesical pressure necessary to produce this experimental reflux is low and ranges between 2 and 12 mm. of Hg; hydrostatic pressure of the bladder contents often sufficed to drive urine into the kidney pelvis. After an experimental reflux had occurred, increased vesical pressure often failed to raise the level of the regurgitant column in the ureters of rabbit and dog: these higher pressures had rendered an incompetent valve competent. Control pressures ranging between 8 and 40 mm. of Hg without a preceding infiltration, caused no reflux in the great majority of dogs. The amount of infiltrated fluid necessary to produce reflux varied from 0.2 cc. in the guinea pig to 0.5 to 2 cc. in dog. Spontaneous regurgitation, that is regurgitation without a preceding infiltration, was seen in 4 guinea pigs, 4 rabbits and 2 dogs. Antiperistalsis of the ureters, that is a wave of contraction passing from the bladder to the kidney, was never seen in our animals with experimental reflux. Biopsy of the bladder in rabbit and dog showed edema of the ureterovesical valves after infiltration in most of our animals. Hemorrhages into the submucosa in the neighborhood of the ureteral valves were observed in some. The bladders of 3 rabbits, exhibiting spontaneous reflux without infiltration showed pouting, edematous lips of the ureterovesical orifices. The cause of experimental regurgitation is a non-obstructive edema of the vesical valve; this edema renders the valve flap more rigid and therefore incompetent at relatively low intravesical pressures. Higher intravesical pressures may again render the incompetent valve competent. The experimental results are applied to the human subject because the urinary bladder of dog and of man are quite similar in structure and function. Reasons are presented suggesting that the described type of reflux may cause pyelitis and pyelonephritis.
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PMID:EXPERIMENTAL LOCAL BLADDER EDEMA CAUSING URINE REFLUX INTO URETER AND KIDNEY. 1987 Jun 95

To comprehensively evaluate the occurrence of renal lesions in a variety of nondomestic felids, necropsy cases from 1978 to 2008 were reviewed from a municipal zoo and a large cat sanctuary for those in which the kidneys were examined histologically. Seventy exotic felids were identified (25 tigers, 18 lions, 6 cougars, 5 leopards, 3 snow leopards, 3 clouded leopards, 3 Canadian lynx, 2 ocelots, 2 bobcats, 2 cheetahs, 1 jaguar), and their histologic renal lesions were evaluated and compared. The most common lesion was tubulointerstitial nephritis (TIN); 36 of 70 (51%) cats were affected to some degree. Lymphocytic interstitial nephritis was the most common lesion in the tigers (9 of 25, 36%) and was rarely seen in other species. Although the renal pelvis was not available for all cats, 28 of 47 (60%) had some degree of lymphocytic pyelitis. There was no significant association between the presence of pyelitis and that of TIN. Only 1 cat had pyelonephritis. Renal papillary necrosis was present in 13 of 70 (19%) cats and was significantly associated with historical nonsteroidal anti-inflammatory drug treatment (odds ratio, 7.1; 95% confidence interval, 1.9 to 26.8). Only 1 cat (lion) had amyloid accumulation, and it was restricted to the corticomedullary junction. Primary glomerular lesions were absent in all cats. Intraepithelial pigment was identified in many of the cats but was not correlated with severity of TIN. Despite several previous reports describing primary glomerular disease or renal amyloidosis in exotic felids, these lesions were rare to absent in this population.
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PMID:Renal lesions of nondomestic felids. 2087 11

Presence of air in the kidney can be problematic as the location of the air in different parts of the kidney greatly affects the subsequent management and outcome of the patient. We present here a case of a patient who had emphysematous pyelitis, in which CT scan was able to display presence of air only in the collecting system, thus differentiating this condition from the more fulminant emphysematous pyelonephritis. This leads to a more favourable prognosis and outcome to the patient.
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PMID:Air in the kidney: between emphysematous pyelitis and pyelonephritis. 2161 Oct 13


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