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

Malacoplakia is a rare inflammatory condition characterized by demonstrative Michaelis-Gutmann bodies, which are foamy histiocytes with distinctive basophilic inclusions. Malacoplakia is caused by the inadequate elimination of bacteria by macrophages or monocytes as a result of defective phagocytic activity. Xanthogranulomatous pyelonephritis is characterized by the destruction of renal parenchyma and its replacement by solid sheets of foamy lipid-laden macrophages. Prolonged infection of the kidney, which is frequently caused by an obstruction of the urinary tract, is the pathologic mechanism of that condition. We present a 6-year-old patient with a poorly functioning kidney who had a prolonged recurrent urinary tract infection. The results of histologic analysis revealed an inflammatory infiltration consisting predominantly of foamy and epithelioid histiocytes that contained round intracytoplasmic concretions characteristic of Michaelis-Gutmann bodies. We suggest that malacoplakia might be a stage of xanthogranulomatous pyelonephritis.
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PMID:Renal parenchymal malacoplakia: a different stage of xanthogranulomatous pyelonephritis? 1761 70

Xanthogranulomatous pyelonephritis and emphysematous pyelonephritis are two uncommon variants of pyelonephritis. The combined occurrence is very rare and has not been described in dialysis patients. We report a 78-year-old woman with end-stage renal disease receiving chronic hemodialysis who presented with a one-week history of vague abdominal pain. During the previous 4 months, she had experienced four episodes of urinary tract infection presenting with fever and pyuria which were improved by antibiotic therapy. The urine cultures yielded Klebsiella pneumoniae at all events. Abdominal computed tomography showed the right kidney replaced by multiple hypodense masses. A kidney biopsy demonstrated characteristic pictures of xanthogranulomatous pyelonephritis. Subsequent computed tomography showed gas bubbles formation in the right renal masses suggestive of emphysematous pyelonephritis. Because the patient refused surgical nephrectomy, percutaneous needle aspiration with prolonged antibiotic treatment was done. Follow-up computed tomography demonstrated dramatic regression of the renal mass. This case suggests that xanthogranulomatous pyelonephritis can be complicated by emphysematous pyelonephritis. Furthermore, the unique features in end-stage renal disease patients make the diagnosis of xanthogranulomatous pyelonephritis more difficult.
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PMID:Xanthogranulomatous pyelonephritis complicated by emphysematous pyelonephritis in a hemodialysis patient. 1818 27

Urinary tract infections are the most common urologic disease in the United States and annually account for over 7 million office and 1 million emergency department visits. In adults, diagnosis of urinary tract infection is typically based on characteristic clinical features and abnormal laboratory values. Imaging is usually reserved for patients who do not respond to therapy and for those whose clinical presentation is either atypical or potentially life threatening. Urinary tract infection typically originates in the urinary bladder; when it migrates to the kidney or is seeded there hematogenously, a tubulointerstitial inflammatory reaction ensues, involving the renal pelvis and parenchyma. The condition is characterized as pyelonephritis. Complicated and uncomplicated pyelonephritis, xanthogranulomatous pyelonephritis, and tuberculosis are all urinary tract infections for which imaging evaluation adds diagnostic information important for patient care. Computed tomography (CT), when performed before, immediately after, and at delayed intervals from contrast material injection, is the preferred modality for evaluating acute bacterial pyelonephritis. CT is also preferred over conventional radiography and ultrasonography (US) for assessing emphysematous pyelonephritis. Xanthogranulomatous pyelonephritis is a chronic granulomatous process, induced by recurrent bacterial urinary tract infection. Although US is useful in the diagnosis of this condition, CT is the main imaging tool, as it provides highly specific findings and accurate assessment of the extrarenal extent of disease, which is essential for surgical planning. The increasing prevalence of tuberculosis and continued emergence of antibiotic-resistant strains have significance for genitourinary radiologists, as the urinary tract is the most common extrapulmonary site of tuberculosis. Familiarity with the renal manifestations of the disease--pelvoinfundibular strictures, papillary necrosis, cortical low-attenuation masses, scarring, and calcification--will help in the diagnosis, even in the absence of documented pulmonary disease.
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PMID:Pyelonephritis: radiologic-pathologic review. 1820 42

Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis, which frequently has a pseudotumoral appearance, as a result of which differential diagnosis with malignant renal neoplasia is difficult, especially as there are no specific signs of this lesion. The aim of this article is to notice the various histological, clinical and radiological characteristics, and the different modalities of diagnostic and treatment of this affection.
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PMID:[Xanthogranulomatous pyelonephritis: main imaging features]. 1853 70

Xanthogranulomatous pyelonephritis is an uncommon form of chronic bacterial pyelonephritis characterized by the destruction of renal parenchyma and the presence of granulomas, abscesses, and collections of lipid-laden macrophages (foam cells) replacing the renal parenchyma. This case report illustrates the clinical course of bilateral diffuse xanthogranulomatous pyelonephritis with a subtle manifestation in contrast to those typically presenting with fever, flank pain or urinary tract infection. The patient therefore received supportive treatment for 18 months without hemodialysis, instead of the curative treatment, bilateral nephrectomy, which would have caused immediate loss of residual renal function and dependence on hemodialysis.
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PMID:Bilateral xanthogranulomatous pyelonephritis. 1856 62

A 73-year-old woman with leukemia presented with urinary tract infection, splenic abscess, and a renal mass. Both urine culture and pus culture of the splenic abscess yielded Klebsiella pneumoniae. Percutaneous biopsy of the renal mass confirmed the diagnosis of xanthogranulomatous pyelonephritis. Because of high risk for surgery, the patient received treatment with antibiotic therapy for 2 months. With antibiotic therapy, not only was the splenic abscess cured but follow-up ultrasonography also showed progressive resolution of the renal mass. Xanthogranulomatous pyelonephritis is frequently associated with urinary tract obstruction or nephrolithiasis. In this first report of xanthogranulomatous pyelonephritis in a patient with leukemia and splenic abscess, we provide a short review of xanthogranulomatous pyelonephritis successfully treated with antibiotics only.
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PMID:Xanthogranulomatous pyelonephritis successfully treated with antibiotics only. 1911 30

Xanthogranulomatous pyelonephritis (XGP) is a slowly progressive, chronic kidney infection. It presents with nonspecific symptoms and is definitively diagnosed by surgical examination. Xanthogranulomatous pyelonephritis must be differentiated in the emergency department (ED) from acutely progressive conditions, such as emphysematous pyelonephritis, which require immediate intervention. Xanthogranulomatous pyelonephritis requires nephrectomy; however, emergent kidney removal is not crucial. The low prevalence and nonspecific presentation of XGP increase the importance of recognizing common risk factors and comorbidities, such as type 2 diabetes, hyperlipidemia, and untreated urinary tract infections. Computed tomography (CT) scan is crucial in XGP assessment and should be obtained quickly upon presentation.
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PMID:Xanthogranulomatous pyelonephritis presentation in the ED: a case report. 1993 91

Xanthogranulomatous pyelonephritis (XGP) is a chronic suppurative infectious process that only rarely affects pediatric patients, and most commonly occurs in the setting of a large obstructing calculus. Histologically, XGP is characterized by the presence of chronic inflammation and lipid-laden macrophages. This case report illustrates the radiological, surgical, and pathologic findings in a young patient who presented to our institution for treatment of this uncommon condition. Although rare, xanthogranulomatous pyelonephritis is a clinically important entity that can affect pediatric patients. This condition should be considered in the differential diagnosis for an atypical-appearing renal mass.
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PMID:Xanthogranulomatous pyelonephritis: an uncommon pediatric renal mass. 2133 42

Xanthogranulomatous pyelonephritis is a chronic, inflammatory disease of the kidney rarely found in the pediatric population. We report the case of a 16-year-old boy with fever, microscopic hematuria, and an enlarging cystic renal mass on ultrasonography. The patient had no evidence of renal stones and no known risk factors, other than a recent tattoo performed with unsterile equipment. Because the differential diagnoses included Wilms tumor, he underwent open exploration and nephrectomy. The histopathologic findings were consistent with xanthogranulomatous pyelonephritis, and cultures grew methicillin-resistant Staphylococcus aureus. The etiology was believed to be bacterial seeding from the unsterile tattoo.
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PMID:Xanthogranulomatous pyelonephritis in an adolescent. 2057 4

Xanthogranulomatous pyelonephritis and secondary systemic amyloidosis are relatively common pathologies with innumerable cases being reported now and then. However the association of these entities is an extremely uncommon occurrence with only ten cases described in the literature. Clinical remission of amyloidosis develops in a majority of these patients after removal of the renal lesion. We present a case of this rare association in a young female who under-went nephrectomy for a non-functioning kidney. A histopathological diagnosis of xanthogranulomatous pyelonephritis was made. In addition there were deposits of amyloid in the glomeruli and the interstitial blood vessels.
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PMID:Amyloidosis secondary to xanthogranulomatous pyelonephritis: a rare association. 2058 79


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