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

The most common causes of serious low back pain in children include spondylolysis, Scheuermann disease and musculoligamentous injury. Questions should be asked about the mechanism of onset and exacerbating factors, and the frequency, duration and severity of the pain. The examination should check gait and alignment, flexibility, strength and reflexes, and localize and evaluate the pain. Warning signs of serious problems include constant pain in a child younger than 11 years of age that lasts for several weeks or occurs spontaneously at night, repeatedly interferes with school, play or sports, or is associated with marked stiffness and limitation of motion, fever or neurologic abnormalities. Pain at the lumbosacral junction may suggest spondylolysis or spondylolisthesis. Scheuermann disease is diagnosed by the observance of wedging, irregularity or growth disturbance of three successive vertebrae. Musculoligamentous pain may result from injury to or overuse of muscles or joints of the back. Rare causes include discitis, tuberculosis, bone or spinal cord tumor, pyelonephritis and retroperitoneal infection.
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PMID:Evaluating the child with back pain. 890 Mar 53

We experienced a case of adenocarcinoma occurring in the reconstructed bladder 38 years after ileocystoplasty. The patient was a 48-year-old woman, who had undergone ileocystoplasty and left nephrectomy at the age of 10 for the treatment of tuberculous contracted bladder and left renal tuberculosis. She had often suffered from right pyelonephritis following the operation. She visited our hospital for work-up of a high value of carcinoembryonic antigen (CEA). The findings of cystoscopy, cystogram and urine cytology showed a malignant tumor of the reconstructed bladder. Then, we performed total cystectomy and right ureterostomy. The histopathological examination showed that the tumor was an adenocarcinoma which developed mainly from the ileal segment of the reconstructed bladder.
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PMID:[A case of adenocarcinoma of the reconstructed bladder following ileocystoplasty]. 912 69

Using medical manuscripts and texts from the Byzantine period (330-1453), this article describes various, to date little discussed, aspects of Byzantine nosology, public health and therapeutics. Many diseases in the Byzantine era were widespread and had a high morbidity such as respiratory disease, various kinds of anaemia, pestilential diseases (e.g. quartan fever, plague, dysentery and cholera), parasitic diseases, orthopaedic, rheumatic and psychiatric disorders, trachoma and alcoholism. Other very serious and relatively frequent conditions included leprosy, mania, gout, cancerous tumours and ulcers. Important elements of nephrology and various renal diseases were described and investigated, such as acute and chronic renal failure, acute and chronic nephritis, pyelonephritis, necrotic renal diseases, crush syndrome, and ulcers of the kidneys, i.e. tuberculosis or renal tumours. The microhistology and physiology of the kidneys were first studied by Oribasius, who discerned the existence of the capillaries--tau rho iota chi omicron epsilon iota delta eta--some centuries before Malpighi. He also correctly described the blood circulation, general and pulmonary, as a precursor to Harvey. The first hospitals were organised during the Byzantine period, and the practice of Byzantine medical science and its social applications were regulated by a special medical legislation and deontology. Byzantine medicine was fruitfully connected with the Christian faith and developed the supreme model of the saints unmercenary--alpha nu alpha rho gamma epsilon rho omicron iota--physicians such as Cosmas and Damian (3rd century), Panteleemon (3rd-4th centuries) and the women physicians and miracle-worker saints, Zenais and Philonilla (1st century), the 'friends of peace', and Hermione (1st-2nd centuries).
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PMID:Diseases in the Byzantine world with special emphasis on the nephropathies. 918 37

Xanthogranulomatous pyelonephritis is a particular form of chronic pyelonephritis. It is observed less frequently in children and can sometimes present with a focal pseudoneoplastic appearance. An 11-year-old child was admitted with abdominal pain, alteration of the general state and weight loss without fever or palpable mass. Medical imaging was unable to distinguish between malignant renal tumour or tuberculosis. The diagnosis was confirmed by the inflammatory and purulent appearance of the mass and histopathological examination of the biopsy fragment. Percutaneous drainage of the abscess, combined with antibiotics provided marked improvement. Despite its rarity and its nonspecific clinical features, focal xanthogranulomatous pyelonephritis must be considered in order to propose conservative treatment.
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PMID:[Pseudotumorous focal xanthogranulomatous pyelonephritis in children. Apropos of a case]. 992 42

In 76 patients with genitourinary disorders an identification was carried out of atypical mycobacteria from the pathological material with subsequent categorization thereof into different groups according to Rennieun's classification. There have been established different numbers of recovering atypical mycobacteria, tuberculosis mycobacteria and their myxts in different urological and genital disorders, such as tuberculosis and cyst of the kidney, tuberculosis of appendages, chronic pyelonephritis, adenoma of the prostate. The conducted studies showed that the bulk of atypical mycobacteria identified in the above-named patients belonged in group II (scotochromogenes) and IV (fast-growing) as per Rennieun's classification.
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PMID:[The recovery of atypical mycobacteria from patients with urogenital diseases]. 1020 69

The most frequent cause of upper urinary tract infection remains E. coli. Other organisms are found in complicated infections associated with diabetes mellitus, instrumentation, stone, and immunosuppression. The pathogenesis of acute pyelonephritis is reviewed herein, with an emphasis on the virulence factors responsible for its initiation, including urothelial adhesion by P-fimbriae of E. coli and other common factors including hemolysin and aerobactin. Renal damage does not always ensue following such infection. It is seen when toxic oxygen radicals are released during the ischemic episode and the respiratory burst of phagocytosis is marked and prolonged. These events occur when effective antibacterial treatment is delayed when the diagnosis is not made early or when socioeconomic factors prevent treatment. The scarring of chronic pyelonephritis leads to the loss of renal tissue and function and may progress to end-stage renal disease. With effective antibacterial therapy, the immune response by both T and B lymphocytes leads to antibodies that assist in bacterial eradication. Therapy must be both rapid and effective. In many instances, antibacterial agents may be used as outpatient therapy. If the Gram stain shows only gram-negative organisms and if the infection is community acquired, oral outpatient therapy with trimethoprim/sulfamethoxazole or a fluoroquinolone may suffice if the patient has no nausea. When the patient is septic, hospitalization and treatment with parenteral antibiotics are needed. Both ceftriaxone and gentamycin are cost-effective parenteral therapy because only once-daily dosing is needed. If gram-positive organisms are found, an enterococcus should be suspected, and a beta-lactam penicillin such as piperacillin or a third-generation cephalosporin such as ceftriaxone is indicated. If penicillin allergy exists, vancomycin should be used. If the patient does not improve rapidly, diagnostic studies including ultrasound and CT will assist in the diagnosis of obstruction, abscess, or emphysematous pyelonephritis. Most of these complications are now rapidly treated percutaneously, with surgical therapy following as needed. Complicated infections, such as those occurring in patients with anatomic abnormalities, stone, or immunosuppression, are often caused by organisms other than E. coli, and long-term antibacterial therapy often leads to fungal infections such as candidiasis. A recrudescence of tuberculosis is occurring, often with resistance to antituberculous drugs. The increased incidence has been associated with the immunosuppression of AIDS but is also occurring in intravenous drug users, perhaps because of poor nutrition but also owing to noncompliance with treatment. The symptoms of renal tuberculosis are usually limited to fever, frequency, urgency, and dysuria. Hematuria with sterile pyuria is the usual laboratory finding. The young urologist should remember this renal disease in the differential diagnosis of hematuria, because medical therapy can provide a cure.
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PMID:Management of pyelonephritis and upper urinary tract infections. 1058 16

The relationship between a history of selected medical conditions and risk of lymphomas was investigated in a hospital-based case-control study conducted in Northern Italy on 429 incident, histologically confirmed cases of non-Hodgkin's lymphoma (NHL), 158 cases of Hodgkin's disease (HD) and 1157 controls admitted to hospitals for acute conditions. The odds ratios (OR) for NHL were above unity in patients with a history of infectious mononucleosis (OR 2.9), herpes zoster (OR 1.8), pyelonephritis (OR 4.9), tuberculosis (OR 1.8), malaria (OR 1.9), any chronic bacterial diseases (OR 1.7), rheumatoid arthritis (OR 1.7) and psoriasis (OR 2.5). With reference to HD, the ORs were 4.0 for infectious mononucleosis, 2.9 for herpes zoster, 3.3 for pyelonephritis, 2.3 for tuberculosis, 1.4 for chronic bacterial diseases, 2.4 for rheumatoid arthritis, 2.7 for psoriasis and 2.1 for diabetes. The association of NHL and HD with herpes zoster was restricted to the first ten years since the onset of the disease. The relationships between NHL and mononucleosis (OR 12.9), malaria (OR 2.8) and psoriasis (OR 14.0) were stronger for cases aged > or = 60 years, and that with tuberculosis (OR 3.5) was stronger for younger cases. For HD, the positive association was stronger for cases aged > or = 40 years for herpes zoster (OR 3.8) and diabetes (OR 2.6). An increased risk of NHL was found in association with poliomyelitis (OR 1.6) (restricted to cases aged > or = 60 years, OR 4.0) and BCG immunizations (OR 1.6), but not with vaccination against smallpox, tetanus and diphtheria; increased risks of HD were found in relation to poliomyelitis and BCG immunization in cases aged > or = 40 years (OR respectively 2.5 and 2.1), or > or = 50 years (OR 4.3 and 2.2). Thus, our results confirm the association between a history of several chronic infectious and inflammatory diseases and the risk of NHL or HD, and are compatible with a role of chronic immunological alterations in the aetiology of lymphomas.
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PMID:Medical history and risk of Hodgkin's and non-Hodgkin's lymphomas. 1077 11

From pathological point of view the chronic renal infections include two types, interstitial chronic pyelonephritis and granulomatous pyelonephritis, namely xanthogranulomatous, malacoplakia and renal tuberculosis. Indications for imaging modalities are more common compared to the acute types and allow to depict both factors causing obstruction and infection such as stones ant the renal and extrarenal extension of the disease. In this article the authors review the findings and the role of plain film and urography, computed tomography and ultrasonography.
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PMID:[The imaging of chronic renal infections]. 1092 90

Despite improvement in graft survival, infection continues to be an important cause of morbidity and mortality after kidney transplantation. We analyzed the clinical courses and outcomes of 16 transplanted patients with positive cultures for mycobacterium tuberculosis. In the course of a 20 year period, there were 13 cases of tuberculosis registered that developed in 456 patients who underwent kidney transplantation in our department, and in three refugees transplanted in other centers (a prevalence of 3.13%). Five of them developed tuberculous infections during 1997. Five patients had residual tuberculosis in preoperative chest X-ray, and specific pyelonephritis as an underlying kidney disease in two of them. All patients with treated with triple immunosuppressives. Before tuberculosis onset, 14 patients experienced one or more episodes of acute rejection and were treated with steroid pulses, ALG or OKT3. Tuberculosis was diagnosed after a period of 1.5 months to 10 years after transplantation. At the time of an infection, the graft function was normal in eight patients and chronic graft failure was evident in eight patients (sCr 210-700 micromol/L). The infection was pulmonary in 12 patients; urinary in two; disseminated in two; pulmonary and urinary, pulmonary and intestinal, and pancytopenia in one patient. All patients were treated with rifampicin and isoniazid in addition to ethambutol for the first two-month period. Treatment lasted from 1-22 months. With 14 patients favorable microbiological responses were registered. Two patients died within the first six months (both with disseminated disease), and the mortality rate was 14.3%. Throughout the followup period, the graft function remained stable and normal in eight patients who had normal graft function at the time of infection onset. Although six patients recovered, progressive graft failure developed and hemodialysis was restarted in one patient two months after antituberculous therapy introduction, and in two patients three years later. Four patients died 2-14 months after AT therapy withdrawal. The causes of death were severe liver failure, cerebrovascular insult and CMV.
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PMID:Does tuberculosis after kidney transplantation follow the trend of tuberculosis in general population? 1125 35

The incidence of tuberculosis has been increasing in recent years, and its treatment has also become challenging. The diagnosis of renal tuberculosis is often difficult and delayed. Early and correct diagnosis of tuberculosis with different organ system involvement is very important and can be easier with ultrasonography, computed tomography and/or magnetic resonance imaging. Although renal tuberculosis is the result of hematogenous spread more commonly from the lungs, less than 5%, of patients with urinary tract tuberculosis have active pulmonary disease. Renal tuberculosis may show variable radiological findings depending on the stage of the infection. Although an end-stage "autonephrectomized" kidey in tuberculosis is classically defined to be small in size, enlargement may on rare occasions be observed, which is the case in our patient. This form greatly mimics diffuse xanthogronulomatous pyelonephritis. Both diseases show thickening of the perirenal fasciae and spread of inflammation into the adjacent organs. Computed tomography and magnetic resonance imaging may show some specific features to differentiate these two entities.
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PMID:Renal tuberculosis mimicking xanthogranulomatous pyelonephritis: ultrasonography, computed tomography and magnetic resonance imaging findings. 1202 10


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