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

Urinary tract infection is a common problem affecting every fifth woman during her life. Although the clinical diagnosis is easy, and is based mainly on symptoms and microscopy of urine sediment, the microbiological diagnosis is often difficult. Escherichia coli is the main etiologic agent, causing urinary tract infection in approximately 80% of the cases. Adherent, uropathogenic E coli strains are associated with pyelonephritis and relapse. Staphylococcus saprophyticus is a frequent cause of urinary tract infections in fertile women. The urethral syndrome, caused by several agents, is an important factor in differential diagnosis. Microscopy is the cornerstone of all diagnostics of urinary tract infections. A urine culture that is taken, handled, transported and interpreted satisfactorily can provide valuable information with respect to diagnosis, treatment, prophylaxis and epidemiology.
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PMID:[Urinary tract infections. Views on microbiological diagnosis and resistance determination]. 199 85

We designed a retrospective study to determine the incidence of P-fimbriated Escherichia coli in patients with asymptomatic bacteriuria, acute urethral syndrome, bacterial cystitis, acute pyelonephritis, possible acute pyelonephritis, and acute and chronic prostatitis. In addition, we compared the incidence in uncompromised vs compromised hosts, inpatients vs outpatients, and children vs adults. P-fimbriated E coli were isolated in more than 80% of uncompromised patients with either acute pyelonephritis or acute prostatitis. In clinically compromised patients having these disorders, the incidence dropped to approximately 30% (P less than .025). Neither age nor inpatient/outpatient status was a significant factor. We stress the importance of P-fimbriation as a virulence factor in acute pyelonephritis and acute prostatitis caused by E coli, though these diseases may be caused by less virulent organisms in compromised patients. Thus, patients with acute pyelonephritis or acute prostatitis caused by E coli negative for P-fimbriae probably should be considered compromised; the compromising factor should be determined as a guide to subsequent treatment.
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PMID:P-fimbriated Escherichia coli urinary tract infection: a clinical correlation. 289 72

Symptomatic urinary tract infection is a common complaint in women. A convenient classification of such infection is bacterial pyelonephritis, bacterial cystitis, and "urethral syndrome," on the basis of symptoms and urine culture colony count. Pyelonephritis can be treated in the office if the patient is not toxic, follow-up is possible, and the patient can tolerate oral medication. Treatment commonly is given over a period of two to six weeks. Single-dose therapy is now the preferred treatment for bacterial cystitis, and several agents are effective. When an infectious agent can be identified in urethral syndrome, antibiotic therapy is useful. Patients in whom an agent cannot be identified may be found to have interstitial cystitis. Recurrence can be a matter of relapse but usually results from reinfection. The causes of relapse usually can be approached surgically, while reinfection must be treated with behavior modification and prolonged antibiotic prophylaxis.
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PMID:Urinary tract infection in women. New perspectives on office management. 684 73

Special problems peculiar to urinary tract infections (UTIs) in the female include higher frequency than in males, recurrent infections, restrictions on antibiotic use during pregnancy, and the "urethral syndrome." Current concepts in the management of UTI include recognition of significant infection with total count of less than 100,000 organisms per milliliter; awareness that untreated UTI usually does not lead to progressive renal failure; importance of differentiating between upper and lower UTI; use of antibody coating of bacterial for distinguishing upper from lower UTI; evidence that 1-day (or single-dose) therapy may be adequate for cystitis, whereas pyelonephritis usually requires treatment beyond 2 weeks; evidence of effective prophylaxis; and indications that Chlamydia may be responsible for some cases of urethral syndrome.
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PMID:Urinary tract infections in the female. 699 Mar 31

The term "urinary tract infection" covers a variety of different diseases including acute and chronic pyelonephritis, cystitis, urethral syndrome and asymptomatic bacteriuria. Each of these terms is defined and etiology, diagnostic procedures as well as modern therapy are discussed in detail.
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PMID:[Pyelonephritis. Definition, etiology, diagnosis and therapy (author's transl)]. 701 31

Ureaplasma urealyticum organisms (ureaplasmas), Mycoplasma hominis, M. fermentans, M. primatum, M. Salivarium and M. pneumoniae have been isolated from the genitourinary tract. The first two of these microorganisms are found most frequently. M. hominis is a cause of some cases of postpartum and postabortal fever, acute pyelonephritis and pelvic inflammatory disease. Ureaplasmas have been associated with chorioamnionitis, habitual spontaneous abortion, low birthweight, the urethral syndrome in women, and nongonococcal urethritis (NGU) in men; but the difficulty of proving an etiological relationship is emphasized. However, in NGU there is accumulating evidence to indicate that ureaplasmas cause some cases. Some patients suffering from NGU, from whom ureaplasmas, mycoplasmas and chlamydiae cannot be isolated, respond to tetracycline therapy. This has suggested that a tetracycline-sensitive microorganism might be responsible. In this context, the isolation of a glucose-metabolizing mycoplasma from the genitourinary tracts of 2 of 13 men with NGU is of interest. This mycoplasma, serologically different from all other tested, has the structural and biological features of a pathogenic organism.
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PMID:Urogenital mycoplasma infections of man: a review with observations on a recently discovered mycoplasma. 728 95

A review about recent aspects on diagnosis and clinical management of urinary tract infection (UTI) is presented. There is a wide variation in clinical presentation of UTI which include different forms as cystitis, pyelonephritis, urethral syndrome and the clinical relevance of asymptomatic bacteriuria and low-count bacteriuria that must be distinguished from contamination. Pathogenetic aspects concerning bacterial virulence as well as host factors in susceptibility to UTI as urinary tract obstruction, vesicoureteral reflux, indwelling bladder catheters, pregnancy, diabetes mellitus, sexual activity, contraceptive methods, prostatism, menopause, advanced age and renal transplantation are discussed. Diagnostic criteria and the most common tests utilized for differentiation between lower and upper UTI have been reviewed. The authors conclude that a careful evaluation of the underlying factors is required for the correct diagnosis of UTI and to prevent recurrence and that appropriate strategies and specific therapeutic regimens may maximize the benefit while reducing costs and adverse reactions.
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PMID:[Diagnosis and clinical management of urinary tract infection]. 1272 22