Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Back pain and a cervicobrachial syndrome, as well as progressive sensory and motor deficits as far as symptoms of paraplegia, developed in two dialysis patients two and five years after the start of dialysis. One was a 60-year-old woman with pyelonephritis, the other a 55-year-old man with glomerulonephritis. There were typical radiological signs of destructive spondylarthropathy (narrowed intervertebral spaces and slippage of the vertebral bodies). The female patient required several operations (spondylothesis and orthothesis) and both patients received daily 10,000 IU vitamin D and 3-4 g calcium carbonate. In the woman the destructive process no longer progressed one year after onset of symptoms, but she still required many analgesics. She died three months later of circulatory failure. The man died four weeks after the onset of symptoms from purulent meningitis. At autopsy only renal fibrous ostitis was still demonstrable. Amyloidosis resulting from an increase in beta 2-microglobulin level were excluded by both histological and immunohistochemical examinations.
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PMID:[Destructive spondylarthropathy in dialysis patients]. 198

During a 4.5-year period, over 2% of 24,000 obstetric patients at Parkland Memorial Hospital were admitted for acute pyelonephritis. Chills accompanying back pain was the most common presenting complaint in the se 656 women; lower urinary tract symptoms and nausea and vomiting were also common. All women had fever and, with few exceptions, costovertebral angle tenderness. In most cases, the clinical impression was confirmed by bacteriuria. Significant transient renal dysfunction was demonstrated in 60 (21%) of 282 women tested. Of 501 of the 656 women with antepartum pyelonephritis who delivered at Parkland Hospital, 23% developed recurrent pyelonephritis; in half of these patients, this recurrence was antepartum. Of 393 and of the 501 women tested, 20% had asymptomatic bacteriuria at delivery. An 8- to 13-year follow-up study was done on 208 of the 501 women following the index pregnancy; 42% were treated for 1 or more episodes of symptomatic urinary infection when not pregnant. In 140 of the 501 women, a subsequent pregnancy was cared for at Parkland Hospital. Thirty-eight percent of these patients had at least 1 urinary infection during 1 of these pregnancies: 29% had pyelonephritis, and 9% had either asymptomatic bacteriuria or cystitis.
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PMID:Acute pyelonephritis in pregnancy: an anterospective study. 724 84

Herein, we report two cases of squamous cell carcinoma of the ureter. The first case was in a 56-year-old-male. Total cystectomy and ileal conduit were performed because of bladder tumor suspected to be accompanied by carcinoma in situ and atrophic urinary bladder induced by chronic cystitis in December, 1993. Pathological examination revealed transitional cell carcinoma (TCC) > squamous cell carcinoma (SCC), G2 > G1, INF beta, pT1, 1y1, v1. He complained of back pain under medical observation in December, 1994. Left hydronephrosis was found and antegrade pyelography showed leakage from the left pelvic ureteral junction. Urinary cytology revealed class V and suggested TCC. He received left nephroureterectomy, and pathohistological examination of resected specimen revealed SCC, INF gamma, pT3, pRo, pLx, pVx, pNo, pMo. CABO chemotherapy (cisplatin, methotrexate, bleomycin, vincristine) was performed postoperatively. The second case was in a 61-year-old female. She complained of macrohematuria in the course of observation of pyelonephritis. Drip infusion pyelography showed right hydronephrosis and retrograde ureterogram revealed stenosis of the right lower ureter. Urinary cytology revealed class V. Nephroureterectomy and bladder cuff were performed. The tumor was histologically diagnosed as SCC > TCC, INF beta, pT3, pRo, pLo, pVo, pNo, pMo. Postoperatively, CABO chemotherapy was performed. So far, no recurrence has been observed. Fifty five cases of squamous cell carcinoma of ureter were collected from the Japanese literatures including our cases.
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PMID:[Two cases of squamous cell carcinoma of the ureter]. 853 90

A 76-year-old woman presented with spiking fever and right back pain. Ultrasonography (US) revealed that her right kidney was enlarged. Computed tomography (CT) showed the parenchyma was replaced by non-enhancing masses but the overall kidney shape was maintained. These findings were compatible with those of xanthogranulomatous pyelonephritis (XP). The nonenhancing masses on CT coincided with the multiple butter yellow nodules of the resected kidney and microscopically these lesions were proved to be abscesses with xanthoma cells. In this case, the US and CT findings reflected the pathological feature of XP and thus these techniques are thought to be useful for the diagnosis of XP.
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PMID:Xanthogranulomatous pyelonephritis. 926 Jul 79

Although septic shock has a high mortality rate of 43%, recently the endotoxin adsorption column was established and its efficacy is interesting. We report a very effective case of endotoxin adsorption the rapy for septic shock due to acute pyelonephritis. A 59-year-old man with chief complaints of pyrexia and right backache was referred to our hospital with a small right ureteral stone (4 mm) associated with a low degree of right hydronephrosis. Since it was diagnosed as right acute pyelonephritis, antibiotics were administered; and then septic shock occurred on the day of hospitalization. Endotoxin adsorption therapy was performed for two days and hemodynamic stability was achieved. The concentration of blood endotoxin was reduced remarkably and the efficacy of endotoxin adsorption therapy was suggested.
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PMID:[A case of effective endotoxin adsorption therapy for septic shock due to acute pyelonephritis]. 1119 1

This report describes a 56-year-old man with a ruptured infected abdominal aortic aneurysm secondary to Salmonella bacteremia, initially presenting as acute pyelonephritis. Spike fever with severe back pain continued despite empiric antibiotic treatment at a local hospital. Hypotension with a sudden hemoglobin drop was observed on the second hospitalization day. Abdominal computed tomography to further examine the bleeding focus confirmed a rupture of the mycotic abdominal aortic aneurysm. This case was successfully treated through prompt surgical intervention and aggressive protracted antibiotic therapy. The case presented herein raises concerns about the uncommon but life-threatening mycotic aneurysm presented initially as acute pyelonephritis. Early diagnosis and appropriate surgical and antibiotic treatment of the Salmonella mycotic aortic aneurysm is crucial for a satisfactory outcome.
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PMID:Mycotic aneurysm presenting as acute pyelonephritis. 1238 Sep 16

An 18-year-old female, who had undergone antireflux surgery for bilateral vesicoureteral reflux 5 years ago, was admitted to our department with complaints of fever and left-sided back pain. Bilateral renal stones and pyelonephritis were diagnosed after roentgenography, ultrasonography and urinalysis. Pyelonephritis was successfully treated with antibiotics and the left renal stone was completely disintegrated with extracorporeal shock wave lithotripsy. Spectrophotometric analysis revealed that the stone was composed of pure ammonium urate (AU). The patient had not experienced any episodes of urinary tract infection from the antireflux surgery until the present event, but had lost 20 kg in body weight during the last year due to a low-caloric diet and laxative abuse. AU urinary stones have been infrequently reported in Japan, and they are supposed to be associated with a low-caloric diet, laxative abuse, and anorexia nervosa.
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PMID:[A case of ammonium urate urinary stone]. 1523 92

A 40-year-old woman with diabetes mellitus was admitted to our hospital for a high fever and left back pain. She was initially diagnosed with acute pyelonephritis by laboratory data and started with intravenous antibiotics. However, her general condition worsened. Computed tomography (CT) showed a gas shadow within the left renal parenchyma and we made a diagnosis of emphysematous pyelonephritis. Percutaneous drainage guided by CT was performed immediately. She recovered and was discharged. Cultures of the pus grew Escherichia coli. We review previous cases of emphysematous pyelonephritis reported in Japan, and discuss the etiology, treatment and prognosis of such cases.
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PMID:[A case of emphysematous pyelonephritis successfully treated by percutaneous drainage guided by CT and review of previous cases reported in Japan]. 1611 7

An 84-year-old woman with septic shock caused by pyelonephritis is described herein. She was admitted for severe back pain and high fever. Her white blood cell (WBC) count and C-reactive protein (CRP) and endotoxin levels were elevated at 38,000/microl, 40.0 mg/dl, and 8,400 pg/ml, respectively. Her blood pressure was 80/34 mm Hg. Urinalysis revealed occult blood with innumerable WBCs. Plain abdominal radiography showed calcium stones in both kidneys. Septic shock with endotoxemia was diagnosed, and the patient was treated with antibiotics, gamma-globulin, and dopamine. However, her plasma endotoxin level remained high for 3 days. We performed direct hemoperfusion twice using a polymyxin B-immobilized fiber (PMX-F) column with a low priming volume. After PMX-F treatment, the patient's temperature decreased to 36.8 degrees C; her WBC count and CRP level decreased to 9,200/microl and 3.8 mg/dl, respectively. Her plasma endotoxin level decreased to 840 pg/ml after the first treatment and to 188 pg/ml after the second treatment. The next day, her blood endotoxin level further decreased to 32 pg/ml. Her blood pressure increased to 92/60 mm Hg after the first treatment and to 118/76 mm Hg after the second treatment. The patient was discharged on day 26 after admission. Our experience in this case suggests that PMX-F treatment with a low priming volume may be beneficial in elderly patients with septic shock and marked endotoxemia.
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PMID:Polymyxin B-immobilized fiber hemoperfusion with low priming volume in an elderly septic shock patient with marked endotoxemia. 1615 19

A 69-year-old woman, who had been diagnosed with interstitial pneumonia at 66 years of age, was admitted to our hospital because of high fever, purpura occurring on her arms and legs, and renal dysfunction. At the time of admission, her renal function had severely deteriorated (sCr 8.2 mg/dl, 24 h Ccr 6 ml/min), she had a severe high fever (BT 39.5 degrees C), back pain, a white blood cell count of 19,540/,microl, and a CRP level of 26.7 mg/dl. Blood and urine cultures yielded identical strains of E. coli. We diagnosed sepsis caused by pyelonephritis, and started intravenous meropenem trihydrate(MEPM) at 0.5 g/day. Her renal dysfunction was severe, so we started hemodialysis therapy. Immunological examination revealed the presence of ANCA-associated glomerulonephritis. Renal biopsy before steroid therapy confirmed the diagnosis of pauci-immune-type crescentic glomerulonephritis. Based on purpura and interstitial pneumonia, along with rapidly MPO-ANCA-positive progressive glomerulonephritis (RPGN) with acute renal failure, we diagnosed microscopic polyangitis (MPA). To treat sepsis and severe pyelonephritis, we started intravenous immunoglobulin 5 g (100 mg/kg)/day for 5 days before starting immunosuppressive steroid therapy (m-PSL 1 g/day, PSL 20 mg/day) for 3 days. These treatments improved her general condition and immediately improved her renal function. It is important to prevent infection during treatment using conventional immunosuppressive therapy. These findings suggest immunoglobulin therapy to be a safe immuno-suppressive treatment that is efficacious against ANCA-associated glomerulonephritis.
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PMID:[A case of microscopic polyangitis with sepsis due to pyelonephritis]. 1640 32


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