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

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

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

After the failure of conservative treatment of neurogenic bladders, urinary diversion has to be considered. For patients with chronic renal failure, severe dilated upper urinary tracts with deterioration of the renal function and those who are not able to perform a self-catheterization, the colonic conduit diversion is our therapy of choice. In this part of the study, we investigate the long-term safety of our concept for these patients in regard to protecting the upper urinary tracts. Between 1968 and 2002, colonic conduit urinary diversion was performed in 88 patients, in most of them in the era before continent diversion. Overall, 11 patients with a colonic conduit were converted to bladder substitution or continent cutaneous diversion during the follow-up period. These patients are no longer included in the long-term follow-up of colonic conduit patients. Of the 77 patients with colonic conduit diversion, 21 patients were not available for follow-up: 11 were deceased and 10 were lost to follow-up. Three of the deaths were related to nephrological complications in patients who already had impaired renal function before conduit diversion. An average follow-up of 21.8 years (2-32.7; median 23.8 years.) is available in 56 patients with 99 RUs (6 solitary kidneys, 7 nephrectomies). Five non-functioning kidneys were removed after recurrent pyelonephritis and two kidneys with pyonephrosis. Ureter stenoses were corrected in 6% of the RUs. As compared to preoperatively, the upper urinary tracts remained stable or improved in 97/99 RUs at the latest follow-up. A revision of the stoma was necessary in 16% (conduit elongation n =2, stenosis n =7) and calculi formations were treated in 8% of the RUs. For patients with chronic renal failure or who are unable to perform a catheterization of a continent stoma, the colonic conduit is a safe alternative in the long run.
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PMID:Urinary diversion in children and adolescents with neurogenic bladder: the Mainz experience. Part III: Colonic conduit. 1586 55

Renal sonography can be easily performed and provides valuable information concerning the underlying disease process, helping to decide appropriate management. This article reviews the important renal infections, such as pyelonephritis, emphysematous pyelonephritis, renal abscess, hydatid disease, renal tuberculosis, pyonephrosis, and HIV-associated nephropathy.
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PMID:Ultrasonographic evaluation of renal infections. 1714 85

We herewith report 10 patients with xanthogranulomatous pyelonephritis (XGP) who were treated in our department between the years 1988 and 2000. The patients' age ranged from 20 to 60 years (mean 45 years); there were seven males and three females giving a male-female ratio of 2.3:1. Sixty percent of the patients were over 50 years old. The lesion was unilateral in all cases and pyonephrosis was found in seven patients. Nine cases had associated renal stones (90%), which led to non-functioning kidney in all these cases. Two cases had associated fistulae (one uretero-colonic fistula and one reno-cutaneous fistula). One case of focal XGP was found to be associated with renal cell carcinoma while a second patient with diffuse obstructive type of XGP and renal stone had associated transitional cell carcinoma of the renal pelvis. In all patients, the urine culture was negative. Pus culture revealed Escherechia coli in four cases (40%), Salmonella Para B in one, and no organism could be grown in four other cases. One case did not have any pus. All patients were treated with nephrectomy.
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PMID:Xanthogranulomatous pyelonephritis: a retrospective study of 10 cases and review of the literature. 1820 96

Renocolic fistula is a rare clinical entity. In the past, its incidence was high due to infection, especially tuberculosis, and renal stone complications; which gradually reduced with advancements in antimicrobial therapy and better stone management. The incidence of renocolic fistulae, specifically iatrogenic one, has re-emerged due to minimally invasive renal surgery and regular percutaneous nephrostomy placement for various reasons. We reported a case of fifty-five-years-old gentleman who presented to emergency room with left lithiasic pyonephrosis for which percutaneous nephrostomy was placed. Follow up antegrade pyelography diagnosed hydronephrotic left kidney with stone in renal pelvis with fistula communicating to descending colon. Contrast enhanced computer tomography revealed left non excreting kidney with retrorenal colon and percutaneous nephrostomy tube passing through the descending colon. The final diagnosis of post percutaneous nephrostomy renocolic fistula with non excreting left kidney was made and treated with ligation of fistulous tract and nephrectomy. Patient had uneventful recovery and histopathology showed chronic pyelonephritis.
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PMID:Renocolic fistula following percutaneous nephrostomy: a case report. 1996 60

Nephrectomy after pyonephrosis, repeated acute pyelonephritis or chronic pyelonephritis is a challenge for any surgeon, owing to adhesions around the kidney. We encountered an unusual case of post-nephrectomy urinary fistula, as a complication of subcapsular nephrectomy. This occurred as a result of residual renal tissue after nephrectomy, which was subsequently excised using methylene blue as an aid to ensure complete excision. Such a complication has never been reported in existing literature. We reviewed the literature for any such related complications to gather an insight to its occurrence and also present a simple point of technique to avoid such a catastrophe.
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PMID:Pitfalls of subcapsular nephrectomy: report of a case with point of technique to avoid urinary fistula formation. 2039 11

Pyonephrosis refers an infected hydronephrotic kidney which arise from pyelonephritis followed by exudate accumulation in a dilated renal pelvis or hydronephrosis followed by ascending infection. Pyonephrosis may cause serious systemic complications, making prompt and reliable diagnosis critical. Clinical and ultrasonographic findings are used for the diagnosis of pyonephrosis in humans, but these findings have not been investigated in dogs. We reviewed ultrasonographic features in pyonephrosis in 18 dogs. Ten dogs with hydronephrosis were also evaluated to compare with the pyonephrosis patients. In most dogs with pyonephrosis, hyperechoic contents completely filled the dilated renal pelvis (n = 8) or a fluid-debris level was observed (n = 8). Hyperechoic contents were dispersed in renal pelvis in only two of the 18 dogs. Hyperechoic, edematous mesentery, and peritoneal and retroperitoneal effusion, which represented peritoneal and retroperitoneal inflammation, were observed in the perinephric region in 11 dogs. Compared with pyonephrosis, and as expected, hydronephrosis was characterized by anechoic contents within the urine-filled collecting system and there were no definitive findings to suspect peritonitis. Thus, there is a distinct difference in the sonographic appearance of pyonephrosis vs. hydronephrosis in dogs.
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PMID:Ultrasonographic features of pyonephrosis in dogs. 2097 91

Urinary tract infections (UTIs) are a common clinical problem, especially among women. Ultrasound assessment is indicated in case of complicated UTIs, in particular in children, pregnant women and patients with chronic kidney disease. Even though B-mode imaging alone is rarely diagnostic in case of particular kidney infections such as focal and multifocal acute pyelonephritis, Doppler and power-Doppler (PD) techniques are able to increase its sensitivity. Contrast-enhanced ultrasound (CEUS) further improves the signal-to-noise ratio, thus increasing the diagnostic accuracy of ultrasound in case of renal infectious disease. Recent studies performed on kidney transplant recipients have indeed demonstrated the high sensitivity and specificity of CEUS in diagnosing acute pyelonephritis. Moreover, ultrasonography is a useful diagnostic tool in case of kidney abscesses, emphysematous pyelonephritis, early phases of pyonephrosis, and in the evaluation and monitoring of echinococcal cysts. Ultrasound imaging is less specific in diagnosing xanthogranulomatous pyelonephritis, malacoplakia and renal tuberculosis. Finally, several authors recommend routine ultrasound assessment in HIV patients, given the high incidence of renal complications in this population of patients.
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PMID:[Ultrasound assessment in renal infections]. 2322 29

This article reviews the computed tomography and magnetic resonance imaging (MRI) features of renal tuberculosis (TB), including TB in transplant recipients and immunocompromised patients. Multi detector computed tomography (MDCT) forms the mainstay of cross-sectional imaging in renal TB. It can easily identify calcification, renal scars, mass lesions, and urothelial thickening. The combination of uneven caliectasis, with urothelial thickening and lack of pelvic dilatation, can also be demonstrated on MDCT. MRI is a sensitive modality for demonstration of features of renal TB, including tissue edema, asymmetric perinephric fat stranding, and thickening of Gerota's fascia, all of which may be clues to focal pyelonephritis of tuberculous origin. Diffusion-weighted MR imaging with apparent diffusion coefficient (ADC) values may help in differentiating hydronephrosis from pyonephrosis. ADC values also have the potential to serve as a sensitive non-invasive biomarker of renal fibrosis. Immunocompromised patients are at increased risk of renal TB. In transplant patients, renal TB, including tuberculous interstitial nephritis, is an important cause of graft dysfunction. Renal TB in patients with HIV more often shows greater parenchymal affection, with poorly formed granulomas and relatively less frequent findings of caseation and stenosis. Atypical mycobacterial infections are also more common in immunocompromised patients.
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PMID:Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part II. 2398 19


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