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

The cases of 57 girls with reflux of radioopaque iodin solution into the vagina during mictioncystourethrography are reported. In 52.6% (30 cases) no signs of anomalies of the urinary tract or of pyelonephritis were found. For this group of 30 girls pyuria (leucocyturia) was typical (in 86.6%). In contrast, a urinarty-tract infection was found only in a few cases (16.6%). The authors discuss the clinical importance of vaginal reflux and its role in the pathogenesis of urinary-tract infections.
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PMID:[Vaginal reflux during miction-cystourethrography in girls (author's transl)]. 56 70

Recent advances in the understanding of urinary tract anatomy, function, and disease should lead to a reassessment of the clinical approach to urinary tract infection. Many traditional concepts must be seriously questioned in light of new information. These include the belief that pyuria or "typical" signs and symtoms are diagnostic. Diagnosis depends on detection of persistent bacteriuria by careful screening and culture of properly collected uring specimens. Once diagnosis is confirmed, oral administration of a single antibiotic for ten days is usually effective. Patients with suspected pyelonephritis or with recurrent or unresponsive urinary tract infection should be treated with two antibiotics. Success of treatment must always be confirmed by culture after discontinuance of therapy. In all cases, follow-up every one to two months should continue until the patients have remained free of infection for a period of one year. Refractory cases may require radiologic study and referral to a urologist.
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PMID:Urinary tract infections in children and adolescents. 79 Mar 49

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

A case of xanthogranulomatous ureteritis is described and the numerous similarities with xanthogranulomatous pyelonephritis in their clinicopathological presentation are discussed. Of the xanthogranulomatous pyelonephritis symptoms our patient manifested a long history of urinary tract infection, weight loss, urinary obstruction, pyuria and gram-negative bacteriuria. The ureteral lesion was a yellowish nodule, granulomatous and was highlighted histologically by foamy histiocytes with periodic acid, Schiff positive cytoplasmic granules. The lesion mimicked an obstructing neoplasm and a specific granuloma.
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PMID:Xanthogranulomatous ureteritis. 123 94

Clinical usefulness of a newly developed assay kit for ACB (SD-8828) which detects urinary bacteria coating IgG was evaluated and compared to the enzyme antibody plate method. A total of 48 patients including 20 patients with acute simple cystitis and 28 patients with acute or chronic pyelonephritis, who were shown to have pyuria of at least 5 cells/HPF, bacteriuria of at least 10(4) CFU/ml were enrolled in this study. By enzyme antibody method. ABC was positive in 92.9% of patients with upper urinary tract infection and negative in 100% of patients with lower UTI, this difference being statistically significant (p < 0.02). By SD-8828, 85% of positive coincidence rate and 100% of negative coincidence rate, compared to the enzyme antibody technique, was obtained. The overall coincidence rate was high (91.7%). This SD-8828, a new simple assay for ACB, which detects IgG alternating the plate method, may be used as a convenient method in clinical practice.
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PMID:[Clinical evaluation of SD-8828 (antibody coated bacteria assay kit) in urinary tract infection]. 143 89

The aim of this study was to assess the possible relationship between secretor state and the inflammatory response to urinary tract infection (UTI). Girls with recurrent UTI were prospectively studied. They included 61 secretor and 23 non-secretor individuals with 604 episodes of recurrent UTI. The response to each UTI episode was measured as the levels of C-reactive protein, erythrocyte sedimentation rate and the body temperature as well as renal concentrating capacity and pyuria. The levels of C-reactive protein, erythrocyte sedimentation rate and the body temperature were significantly higher in non-secretors than in secretors (p less than 0.04). As a consequence, non-secretors had an increased probability of being assigned a diagnosis of acute pyelonephritis rather than asymptomatic bacteriuria (p less than 0.05). The higher inflammatory response in non-secretors was independent of the Gal alpha 1-4Gal beta adhesin expression of the infecting Escherichia coli strains. The increased inflammatory response to UTI in non-secretors might explain the accumulation of these individuals among patients with renal scarring.
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PMID:Blood group non-secretors have an increased inflammatory response to urinary tract infection. 158 29

Urinary tract infections are a frequent problem in ambulatory practices. According to the localization of the infection and to complicating factors we differentiate between various syndromes with different clinical presentations. Relevant diagnostic criteria are a bacteriuria of greater than or equal to 100 organisms par millilitre or a pyuria of greater than or equal to 5 leukocytes per high power field. For acute cystitis, a treatment for three days is recommended. Cotrimoxazole or quinolones are effective drugs, which are more and more recommended for the treatment of acute pyelonephritis, too.
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PMID:[Urinary tract infections in general practice]. 161 58

The diagnosis of pyelonephritis is based on clinical and laboratory criteria that include fever, flank pain or tenderness, leukocytosis, pyuria, and confirmatory urine culture. A Gram stain of unspun urine can provide an important early clue regarding the etiologic agent. At least 85% of cases are caused by Escherichia coli, but clinicians need to be aware of other potentially aggressive organisms as well. Elderly, diabetic, or immunocompromised hospitalized patients and patients subject to instrumentation present a more complex diagnostic challenge and require more intense parenteral treatment. Prompt diagnosis and proper therapy decrease the risk of serious complications.
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PMID:Acute pyelonephritis. Preventing complications through prompt diagnosis and proper therapy. 173 45

A basic and clinical study was made on the significance of stagnancy of urinary flow as a factor causing urinary tract infections. A bacterial solution was inoculated into the bladder of untreated and diabetic mice with model ascending pyelonephritis. The longer the external urethral opening was clamped, the lower became the value of ID50, thus showing infection easily caused by urinary stagnancy in the bladder. Patients who had UTI within 6 months after prostatic operation were divided into two groups, one with residual urine and the other without residual urine. Then, the type of the causative organism, and the severity of pyuria and bacteriuria were determined. In the former, there were slightly more patients with infection caused by plural bacteria. However, no other differences were observed. The administration of cephem antibiotics revealed no differences in effectiveness between the two groups. In conclusion, stagnancy of urinary flow has been considered a factor easily causing infection. However, so far as residual urine is concerned, it is not an intractable factor in treatment.
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PMID:[The role of stagnancy of urinary flow in causing urinary tract infection]. 178 20

E. coli cause greater than 90% of urinary tract infections (UTI) in childhood. The capacity to adhere to urinary tract epithelial cells characterizes E. coli strains that cause acute pyelonephritis. Galactose alpha 1-4Galactose beta is the minimal receptor for adhering uropathogenic E. coli. Gal alpha 1-4Gal beta-binding bacteria caused significantly higher body temperature, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), pyuria, and lower renal concentrating capacity than E. coli lacking this specificity. The binding bacteria thus appeared to be more potent inducers of acute inflammation. Since inflammation may lead to tissue damage, we examined the relationship of infection with Gal alpha 1-4Gal beta-positive bacteria to renal scarring. The frequency of renal scarring was 5% in boys with Gal alpha 1-4Gal beta-positive and 40% in boys with Gal alpha 1-4Gal beta-negative E. coli. Analysis of binding capacity with the help of a newly developed latex agglutination assay can thus be used as an effective predictor of risk for renal scarring.
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PMID:Bacterial attachment, inflammation and renal scarring in urinary tract infection. 181 92


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