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

Pyelonephritis xanthogranulomatosa is a peculiar manifestation of destructive interstitial nephritis which can be differentiated from other types of pyonephrosis exclusively by microscopic examination. Clinical symptomatology often points towards the existence of a renal tumor. The author analyses the clinical and radiological symptomatology of seven patients treated by him. The angiographic picture presented by pyelonephritis xanthogranulomatosa differs according to the character and extension of the inflammatory tissue lesion. The angiographic picture of the circumscribed and diffuse granular proliferative types resembles that of a poorly vascularised malignoma, whereas the destructive type resembles hydropyonephrosis.
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PMID:[A contribution to radiological diagnostics of xanthogranulomatous pyelonephritis (author's transl)]. 9 1

Perinephric abscess is a rare condition; it may be acute, but can take a chronic and atypical course as a result of incomplete treatment with antibiotics. In this case the diagnosis is often delayed. The most common cause is primary renal disease, with perforating ureteric stones, abscess-forming pyelonephritis, renal carbuncle and pyonephrosis as the most important factors. Diagnosis depends on a varying combination of clinical signs, any of which is not necessarily present and which is not pathognomic, but nevertheless, in their totality, are fairly typical. Characteristic are pain on percussion and pressure, resistance in the renal angle and fever. Laboratory investigations do not contribute to the diagnosis. These only show findings typical of any infection, and frequently a marked anaemia. An infected urine may be suggestive. The traditional clinical and radiological methods may well indicate a space-occupying lesion, but its further elucidation depends on angiography. Renal and perinephric abscesses must be distinguished from other space-occupying renal lesions. Abscesses can usually be distinguished from cysts because they are generally less clearly demarkated and often show a hypervascular margin with a "blush". A further differential diagnosis of perinephic abscess is a peri-renal haematoma. Radiologically, an haematoma also produces a perirenal mass with displacement and compression of the kidney. As with perinephric abscesses, the angiogram shows dilatation and displacement of the capsular arteries. Differences in the neovascularity, as well as in the clinical symptoms, permit differentiation between abscesses and hypovascular carcinomas in most cases, or at least suggest the probable diagnosis.
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PMID:[A urologic-radiological view of perinephric abscesses (author's transl)]. 13 65

1) Cefoxitin (CFX) was administered to seven patients: two with acute pneumonia, two with acute pyelonephritis, one with pyonephrosis complicated to pyelolithotomy, one with acute cystitis and one with CONN syndrome complicated to liver cirrhosis. 2) Response to the CFX treatment was excellent in three patients, good in three, and poor in one. 3) No side effect was observed in all cases. In two patients in whom CFX and furosemide were concomitantly administered, no aggravation of the renal function was observed.
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PMID:[Clinical experience with cefoxitin in the field of internal medicine (author's transl)]. 69 Dec 57

Sonograms of 43 patients with intrinsic and perirenal infectious processes are reviewed. Fourteen had acute pyelonephritis; three, suppurative pyelonephritis; two, focal pyelonephritis; six, renal abscesses; three, infected cysts; six, perinephric abscesses; six, pyonephrosis; and three, chronic pyelonephritis. Sonography had little diagnostic value except for the patients with perinephric abscess. However, it proved valuable as a guide for a percutaneous approach to obtain cells for histologic diagnosis, to obtain fluid to determine chemotherapy, and to perform antegrade pyelography and percutaneous nephrostomy.
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PMID:Sonographic-radiographic correlations of renal and perirenal infections. 99 13

The clinical and radiological features of pyonephrosis are reviewed, based on a consecutive series of 40 cases. There were 32 female and eight male patients, with a peak incidence in the 50-59 year age group. In 63% of cases the right kidney was involved. Almost all patients complained of loin pain and 48% had lower urinary tract symptoms. In 58% of cases a renal mass was palpable. An anaemia, pyuria and elevated blood sedimentation rate were usual. Plain films of the abdomen revealed enlargement of the outline of the involved kidney in 75%, ipsilateral absence of the psoas shadow in 63% and urinary tract calculi in 60%. At high-dose excretion urography a nephrogram was obtained in 58% of cases and a pyelogram produced in 34%. No single clinical or radiological entity emerged, there being an unbroken spectrum of disease ranging from infected hydronephrosis to xanthogranulomatous pyelonephritis. There is an increasing incidence of calculi, loss of the renal and psoas outlines and reduced renal function with increasing chronicity of disease. High-dose excretion urography is the investigation of choice since not only may the diagnosis be established but also there precise pathological state of the involved kidney. Further radiological investigation is infrequently required.
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PMID:Pyonephrosis. 100 Aug 95

The primary objective of this retrospective study was to compare the incidence of urological complications and renal deterioration in post-traumatic quadriplegic patients managed with or without a chronic indwelling urinary catheter. The charts of 57 consecutive patients who sustained traumatic cervical spinal cord injury between 1970 and 1980 were reviewed. All of the patients received the initial management or rehabilitation therapy at our institution. The unique features of this clinical review are that a large cohort of patients was followed for a minimum of 10 years, none of the 57 consecutive patients was lost to followup and a yearly excretory urogram provided an objective assessment of the renal units. The followup, and mechanism, level and degree of injury for the 32 patients managed with and 25 managed without a catheter were similar. Overall, the incidences of renal and bladder calculi, pyelonephritis, gross hematuria, penile/urethral erosion, urosepsis, urethral stricture, epididymitis and pyonephrosis were not significantly different in the catheterized and noncatheterized groups. The Kaplan-Meier analysis of the most recent excretory urogram demonstrated that the incidence of renal deterioration was also equivalent in the catheterized and noncatheterized groups. Our study suggests that the decision to manage quadriplegics with or without an indwelling catheter should not be based on relative risk of complications or renal deterioration. The decision to avoid an indwelling catheter in these patients should reflect patient comfort, convenience and quality of life.
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PMID:A comparison of the urological complications associated with long-term management of quadriplegics with and without chronic indwelling urinary catheters. 845 63

The current status of the pathogenesis of the disease and imaging methods in acute renal infections is reviewed. The spectrum of type of infection includes 1) acute pyelonephritis, 2) acute bacterial nephritis, 3) acute renal abscess, 4) acute pyonephrosis, and 5) infected renal simple cyst. The two most common imaging methods used are ultrasound and computed tomography (CT). Recent experience from the literature suggests that CT offers some advantages over ultrasound particularly in distinguishing degree and type of involvement of the renal parenchyma and in more accurate diagnosis of acute abscess.
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PMID:Acute renal infections. 204 74

20 cases of Xanthogranulomatous Pyelonephritis (XPN) were encountered over an 8 year period, constituting 0.4 percent of the total of 47,370 surgical biopsies, 10 percent of the total of 188 nephrectomy specimens removed for various reasons and 35 percent of the nephrectomy specimens associated with chronic pyelonephritis. This is the largest single series, reported in Indian literature. 16 patients were adults and 4 were children, thus 25 percent of our cases were children, a significantly high proportion. Our youngest patient a 5 1/2 month old male, is to the best of our knowledge, the youngest case reported from India. Males predominated in our series, the M:F ratio being 3:1, this contrasts with western literature in which there is a definite female preponderance. The common presenting symptoms were lumbar pain, fever and palpable non-functioning kidney. 4 cases were complicated by cutaneous sinuses. There was a slight predominance of affectation of the left side over the right side. On gross examination, diffuse lesions were commoner than focal lesions and were seen in children as well. An accurate pre-operative diagnosis was made in only 2 cases, in the rest, the diagnosis was either tuberculosis or pyonephrosis. Thus XPN is quite frequently seen in the adult Indian population and is not as rare in children, as it was once thought to be.
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PMID:Xanthogranulomatous pyelonephritis in children and adults--an 8 year study. 209 99

Ifosfamide (isophosphamide) and mesna (2-mercaptoethane sodium sulfonate) were administered intravenously at monthly intervals to 46 patients with advanced epithelial ovarian carcinoma refractory to or recurrent after cisplatin-containing combination chemotherapy. Initially, ifosfamide was given as 1.5 g/m2/d x 5 days and mesna as 300 mg/m2 every 4 hours for three doses following ifosfamide, but the initial dose of ifosfamide was reduced to 1.2 g/m2 because of toxicity. Four of the patients initially entered were found to be ineligible: two who had had more than one prior chemotherapy regimen and two who did not have ovarian primaries. One patient received an inadequate trial and four patients had discontinuation of therapy because of toxicity, leaving 41 evaluable for response. Three patients (7.0%) had complete responses and five (13.0%) had partial responses for an overall response rate of 20.0%. Response duration ranged from 2.1 to 20.3 + months with a median of 6.9 + months. Two patients died of renal failure, one of whom had no known renal disease and received 1.5 g/m2/d x 5 days ifosfamide. The second patient received the 1.2 g/m2 dose and was found to have chronic pyelonephritis and pyonephrosis at autopsy. Gynecologic Oncology Group (GOG) grade 3 or 4 granulocytopenia was seen in eight (19.5%), grade 3 or 4 thrombocytopenia in four (9.8%), and grade 3 or 4 neurotoxicity in six (14.6%) of the 41 patients evaluable for toxicity. Ifosfamide/mesna is active in epithelial ovarian cancer. GOG trials in untreated patients are being initiated and toxicity is being evaluated.
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PMID:Phase II trial of ifosfamide and mesna in advanced ovarian carcinoma: a Gynecologic Oncology Group Study. 250 41

A 2-month-old infant died of xanthogranulomatous pyelonephritis. Preoperatively pyonephrosis was suspected, because the child presented with a number of inflammatory, septic symptoms. Nephrectomy was performed and histopathology showed the kidney to be affected by xanthogranulomatous pyelonephritis. Postoperatively the child developed persistent attacks of fever and bronchopneumonia that led to his death with signs of pulmonary insufficiency.
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PMID:[Xanthogranulomatous pyelonephritis with fatal outcome in a 2-month-old infant]. 262 49


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