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

Urinary tract infections are a common problem seen in ambulatory practices. For this reason it is important to have a cost-effective management. Clinical history and findings may allow to make the diagnosis. The laboratory costs can be reduced, if in case of cystitis a rapid test for detection of leucocytes replaces the urine culture. Urine cultures can be restricted to patients with complicated urinary tract infections. Single-dose with cotrimoxazole or 3-day treatment with trimethoprim is adequate for acute cystitis. The new quinolones are useful for the outpatient treatment of benign cases of acute pyelonephritis. In case of urethritis and prostatitis, the same drugs have an appropriate antimicrobial spectrum and an ideal bioavailability in the infected tissues.
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PMID:[Urinary tract infections: which studies? Whom to treat?]. 212 Jul 87

The serological response towards Staphylococcus saprophyticus in young women with symptomatic urinary tract infection was measured with an enzyme-linked immunosorbent assay (ELISA) and a direct agglutination (DA) test. In both assays a marked antibody response was found in 2 of 3 patients with acute pyelonephritis caused by S. saprophyticus. Patients with acute cystitis due to S. saprophyticus or Escherichia coli showed antibody titers comparable to those of healthy controls.
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PMID:Antibody response to Staphylococcus saprophyticus in urinary tract infection. 225 64

The urinary excretion of alpha 1-microglobulin (alpha 1M), beta 2-microglobulin (beta 2M), retinol-binding protein (RBP) and N-acetyl-beta-D-glucosaminidase (NAG) as markers of proximal tubular dysfunction was measured in various forms of urinary tract infections (UTI) and in fever due to non-renal infections. The urinary concentration of these proteins was significantly increased in acute pyelonephritis compared with acute cystitis and asymptomatic bacteriuria. Tubular proteinuria and enzymuria could also be demonstrated in subjects with fever of non-renal origin and corresponded to the findings of pyelonephritis. It is suggested that fever per se is the most likely cause of the tubular proteinuria seen in acute pyelonephritis. In localizing an acute UTI characterization of the urinary protein profile seems to have no advantage over a carefully measured body temperature. The urinary excretion of alpha 1M,beta 2M and RBP were highly correlated, while urinary NAG activity was less correlated to these low-molecular weight proteins. Fibrin degradation product D (FDP-D) was detected in the urines in 60% of the patients with acute pyelonephritis and in one third of those with acute cystitis. The estimation of FDP in urine therefore seems to be of little value in the level diagnosis of UTI.
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PMID:Fever and proximal tubular function in acute pyelonephritis. 241 42

Eosinophiluria is considered a useful marker of drug-induced acute interstitial nephritis. However, recognition of eosinophiluria by Wright's staining is technically difficult, and the spectrum of disorders causing eosinophiluria is not completely defined. We have adapted Hansel's stain for the examination of urinary sediment. Whereas there was a variable uptake of Wright's stain by eosinophils in the urine, such eosinophils were readily recognized with Hansel's stain by the presence of bright red granules. The prevalence of eosinophiluria in acute interstitial nephritis was 10 of 11 patients, in acute tubular necrosis none of 30, in acute pyelonephritis none of 10, in acute cystitis 1 of 15, in postinfectious glomerulonephritis 1 of 6, in rapidly progressive glomerulonephritis 4 of 10, and in acute prostatitis 6 of 10. Eosinophiluria in acute interstitial nephritis was demonstrated by Hansel's stain in 10 of 11 patients but by Wright's stain in only 2 of 11 patients. We conclude that Hansel's stain substantially improves the recognition of eosinophiluria as compared with Wright's stain. Eosinophiluria is useful in distinguishing acute interstitial nephritis from acute tubular necrosis. The clinical spectrum of eosinophiluria also includes rapidly progressive glomerulonephritis, acute prostatitis, and occasionally, acute cystitis or postinfectious glomerulonephritis.
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PMID:Eosinophiluria--a new method of detection and definition of the clinical spectrum. 1842 May 15

In order to evaluate effectiveness and tolerance of treatment with 300 mg tablets of enoxacine (one every 12 hours), 30 patients between the ages of 29 and 75 were selected (51.23 +/- 2.19 yrs. was the average age), 4 males and 26 females; 18 patients had acute cystitis, 7 had pyelonephritis, 4 had cystopyelitis, and 1 had urethroprostatitis. Treatment lasted on average of 10.77 +/- 0.52 days, with a minimum of 7 and a maximum of 20 days. Initial culture analysis of urine samples ascertained the presence of microbial pathogens sensitive to enoxacine. After one week of treatment, culture analysis of urine samples did not reveal the presence of these pathogens, all having been successfully eliminated. The improvement of the objective and symptomatic parameters chosen for evaluating the effectiveness of the treatment was found to be rapid and decisive in the majority of patients. The systemic tolerance was good; the side effects were minimal (three cases of slight gastroenteric intolerance). At the end of treatment, results were considered excellent in 18 patients and good in 12, on the basis of the more or less rapid resolution of the clinical and symptomatic situation.
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PMID:[Enoxacin in the treatment of bacterial infections of the urinary tract]. 252 87

Acute urinary tract infection is a major health problem among women, accounting for considerable morbidity and health care costs. We review recent developments in the diagnosis and treatment of these infections. In acute lower urinary tract infection, empiric short-course therapy (single-dose or 3-day therapy) with one of several antibiotics is recommended in the absence of complicating factors. When complicating factors are present, the antibiotic susceptibility profile of the infecting organism should be determined and therapy with an appropriate agent should be provided for 7 days. Ampicillin and related drugs are probably inferior to trimethoprim-sulfamethoxazole in the treatment of occult renal infection. In acute pyelonephritis, most patients require hospitalization and treatment with intravenous antibiotics until they can take oral medications. In uncomplicated cases, a single broad-spectrum intravenous agent can be used initially, followed by an oral agent selected on the basis of antibiotic-susceptibility testing results. Patients with uncomplicated acute pyelonephritis who are less ill can be managed with oral therapy as outpatients, again with reference to the results of antibiotic-susceptibility testing. Complicated acute pyelonephritis requires more aggressive diagnostic and therapeutic measures. Therapy for uncomplicated acute pyelonephritis should be given for 14 days. The role of post-therapy cultures in the management of urinary tract infection is not well defined, but cultures probably can be safely omitted in most cases of uncomplicated acute cystitis.
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PMID:Urinary tract infections in women: diagnosis and treatment. 236 59

The development of renal scarring was analyzed prospectively in 241 boys with their first known episode of symptomatic urinary tract infection (140 acute pyelonephritis, 61 acute cystitis, and 40 nonspecific). Of 197 boys undergoing urography, 22 (11%) had scars; 20 were in the pyelonephritis group. Vesicoureteral reflux occurred in 81% of those with scarring, compared with 20% of those without scarring. The bacteria causing the first episode of urinary tract infection in each patient were saved, and Escherichia coli organisms were characterized for the expression of both galactose-alpha (1----4)galactose-beta (Gal-Gal)-specific adhesins and pap homologous DNA. Scarring occurred in 41% and other renal abnormalities in 11% of boys infected with bacteria that did not bind Gal-Gal (Gal-Gal negative), compared with 5% and 1%, respectively, in those infected with Gal-Gal-binding strains (Gal-Gal-positive) (relative risk 8.3; 95% confidence limits 3.3 to 20.4; p less than 0.001). That boys infected with Gal-Gal-negative strains more often had reflux did not explain the increased risk for renal scarring in this group. The possibility that the phenotypically negative strains could be induced to express Gal-Gal adhesions in vivo was excluded by dot blot analysis, which showed the absence of pap homologous DNA in all but one of the Gal-Gal-negative strains. The results suggest that the absence of Gal-Gal-specific adhesins in E. coli can be used as an indicator of risk for renal scarring and the need for radiologic examination.
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PMID:Bacterial attachment as a predictor of renal abnormalities in boys with urinary tract infection. 268 19

The diagnosis of urinary tract infection is based largely on quantitative urine cultures. The usefulness of qualitative information about the virulence of the infecting bacteria remains undefined. Ability to attach to human uroepithelial cells is one characteristic of the pyelonephritogenic clones, as well as a virulence factor per se. The identification of host cell receptors for attaching bacteria has permitted the construction of agglutination tests for simple detection of bacterial binding properties. In the present study, the reactivity with Gal alpha 1----4Gal beta-latex [galactose alpha (1----4)galactose beta-latex] and globotetraosylceramide-latex was analyzed for strains from patients with acute pyelonephritis (n = 135), acute cystitis (n = 121), and asymptomatic bacteriuria (n = 119) and from the fecal flora of healthy children (n = 120) and compared with agglutination of human blood group P1 and p, as well as guinea pig, erythrocytes. The reactivity by bioassay and the receptor-specific assays were significantly correlated. The frequency of positive reactions among the pyelonephritis isolates was 78.5% with the globotetraosylceramide-latex reagent, compared with 41% for the cystitis isolates, 25% for the asymptomatic bacteriuria isolates, and 13% for the fecal isolates. The combination of bioassays and receptor-specific assays increased the resolution of adhesins. Thus, adhesins reacting with human p erythrocytes frequently were coexpressed with Gal alpha 1----4Gal beta-specific adhesins. The receptor-specific assays provide a refined reagent to resolve bacterial binding specificities, as well as a potential tool for clinical diagnosis.
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PMID:Binding to galactose alpha 1----4galactose beta-containing receptors as potential diagnostic tool in urinary tract infection. 288 Aug 68

A sandwich ELISA assay has been formatted from two commercially available murine monoclonal antibodies, URO-4 and URO-4a, directed against a 120,000 dalton glycoprotein, the adenosine deaminase binding protein (ABP), found on the brush border of the renal proximal tubular epithelial cell. Untimed urine samples from 37 normal individuals and urinary ABP less than 0.1 AU; 37 patients with pure glomerular disease had ABP less than 0.4 AU (with 29, or 76% less than 0.2 AU); 10 patients with pre-renal azotaemia had ABP less than 0.6 (with 8, or 80% less than 0.3 AU). In contrast, 79 patients with post-ischaemic acute tubular necrosis had ABP greater than 0.6 AU. Acute renal failure due to myoglobinuria, contrast dye, and aminoglycoside toxicity were all associated with urinary ABP greater than 1.0 AU. In addition, all six patients with acute bacteraemic pyelonephritis had ABP greater than 0.7 AU, as opposed to ABP less than 0.2 AU in the urines of 12 women with acute cystitis. We conclude that this monoclonal antibody based urinary assay is a sensitive measure of renal proximal tubular injury, reliably distinguishes acute tubular from glomerular disease, and may be helpful in differentiating forms of urinary tract infection.
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PMID:Diagnosis of renal proximal tubular injury by urinary immunoassay for a proximal tubular antigen, the adenosine deaminase binding protein. 288 57

Urinary tract infections complicate 7-10% of pregnancies. Early detection and treatment of bacteriuria prevents most cases of pyelonephritis and its associated maternal and neonatal morbidity. The high risk for recurrence of bacteriuria and pyelonephritis mandate close monitoring of previously infected women and may require chronic suppressive therapy through the remainder of pregnancy. Acute cystitis is a distinct syndrome with a low recurrence rate and rarely associated with pyelonephritis.
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PMID:Treatment of urinary tract infections during pregnancy. 304 27


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