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)

A 70-year-old man was referred to our hospital for right back pain. His past history included human immunodeficiency virus infection, which had been treated with atazanavir for 7 years. Abdominal and pelvic computed tomographic scan showed right hydronephrosis due to a strongly suspected right ureteral radiolucent stone. He underwent indwelling of a right ureteral stent because of obstructive pyelonephritis due to the ureteral stone. After improvement of the pyelonephritis, he underwent transurethral ureterolithotripsy for the right ureteral stone. Stone analysis showed the atazanavir stone. He has been followed up for 8 months without evidence of recurrence. Herein, we report this rare case of an atazanavir stone in Japan, which was confirmed by calculus analysis, and present a review of the literature.
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PMID:[A Case of Atazanavir Urolithiasis Diagnosed by Stone Analysis]. 2693 33

Primary aortoduodenal fistula (PADF) is a direct communication between the abdominal aortic aneurysm (AAA) and duodenum. It is a rare entity and causes life-threatening gastrointestinal hemorrhage. Diagnosis requires a high index of clinical suspicion, and surgery offers the only hope for survival. We present a 73-year-old male who was initially admitted to the hospital with back pain and fever. He was diagnosed with pyelonephritis and treated with antibiotics. Computed tomography of the abdomen showed an AAA, but no aortoduodenal fistula was seen. Twelve days later, he was admitted to the hospital as he was hemodynamically unstable. An emergency laparotomy revealed a PADF which was repaired. The aortic aneurysm was repaired with an in situ silver graft and a bifemoral bypass. However, the patient developed severe graft infection and later succumbed.
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PMID:Primary Aortoduodenal Fistula-A Case Report and a Review of the Literature. 2717 58

Renal colic (RC) represents nearly 2% of emergency department admissions. RC is defined by the occurrence of back pain which may radiate towards the abdomen and external genitals. In adults, the obstruction is caused by a urinary stone in 80% of cases. The 20 % of non-stone related RCs are due either to an intrinsic obstruction (pyeloureteral junction stenosis, ureteral tumor, ...) or an extrinsic compression (pelvic tumor, lymphadenopathy ...). In over 90% of cases, an RC does not require hospitalization and is treated with medication. In contrast, complicated renal colic (CRC) requires hospitalization with specialized care. Obstructive pyelonephritis (OPN) is a form of CRC and the diagnosis should be considered in a clinical presentation of "renal colic" with acute pyelonephritis. This is a true emergency requiring surgical drainage of the upper urinary tract upstream of the obstacle, as well as antibiotic therapy. It must be kept in mind that some clinical presentations may be atypical, especially in the elderly, which can delay the diagnosis and, thus, the management. The gold standard for diagnosis is CT urography.
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PMID:[How I TREAT... A RENAL COLIC]. 2733 39

UTI may involve the lower or upper urinary tract and may be uncomplicated or complicated. The emphasis of this chapter is uncomplicated UTI. The diagnosis of uncomplicated cystitis (bladder infection) and pyelonephritis (kidney infection) is usually easily made based on the clinical presentation, whereas the diagnosis in patients with complicated UTI is often more complex. Thus uncomplicated cystitis is usually manifested by dysuria, frequency and/or urgency without fever, and pyelonephritis is usually manifested by fever and back pain/costovertebral angle tenderness. However, pyuria is usually present with UTI, regardless of location, and its absence suggests that another condition may be causing the patient's symptoms. Treatment of cystitis is usually straightforward with one of several effective short-course antimicrobial regimens, although antimicrobial resistance continues to increase and can complicate treatment choices in certain areas. Likewise, antimicrobial resistance has complicated our management of uncomplicated pyelonephritis since resistance of uropathogens to the fluoroquinolone class, the mainstay of oral treatment for pyelonephritis, is increasing worldwide, and some of the other agents used for cystitis are not recommended for pyelonephritis due to low tissue levels. The goal of prevention of recurrent cystitis is to minimize the use of antimicrobials and there are several research efforts in progress to develop effective and safe antimicrobial-sparing preventive approaches for this common condition.
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PMID:Diagnosis, Treatment, and Prevention of Urinary Tract Infection. 2808 35

Xanthogranulomatous pyelonephritis (XGP) is a rare form of pyelonephritis associated with repeated infection, chronic inflammation, and obstruction. Various fistulas, including those to the intestine, are a known association with XGP. Here, a 55-year-old woman with a history of multiple previous renal calculi presented with dysuria and back pain. Contrast-enhanced computed tomography (CT) revealed a soft tissue density in her renal pelvis and perirenal space consistent with XGP along with a tract connecting the upper pole of her right kidney to the second portion of the duodenum. This finding was subsequently confirmed during percutaneous nephrostomy placement, stent placement, a small bowel follow-through study, and upper endoscopy. She was diagnosed with XGP with associated renoduodenal fistula, eventually treated by open nephrectomy with fistula takedown. Histopathologic analysis was consistent with the diagnosis of XGP with no malignant or infectious cause of the fistula. XGP should be considered in the diagnosis of patients with dysuria and back pain, especially when a history of obstruction or chronic inflammation. Associated fistulas should also be considered prior to surgical management to prevent complications.
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PMID:A Case of Xanthogranulomatous Pyelonephritis Associated with Renoduodenal Fistula. 2842 36

We here report the case of a 55 year-old man presenting with right renal colic and with a history of intermittent lower back disorders. At the time of admission, clinical examination showed lower back pain on contact. Renal ultrasound objectified heterogeneous mass at the lower pole of the right kidney with dilation of lower calyx groups. Abdominal CT scan confirmed the presence of right inferior renal polar lesion characterized by mixed density, associated with significant hydronephrosis eroding the renal parenchyma upstream of a voluminous pyelic coralliform lithiasis. The patient underwent nephrectomy with anatomo-pathological examination revealing chronic inflammation of the renal parenchyma characterized by macrophages associated with monocytes and lymphocytes with spongy cells and fibrosis. Anatomo-pathological result was compatible with a diagnosis of xanthogranulomatous pyelonephritis. Xanthogranulomatous pyelonephritis is a relatively rare chronic pyelonephritis whose symptoms resemble those of a pseudotumor. The diagnosis is suspected on the basis of clinical arguments and on laboratory tests and may be evoked quite exclusively on the basis of preoperative CT scan. Kidney cancer was its main differential diagnosis.
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PMID:[Renal tumor or pseudotumoral xanthogranulomatous pyelonephritis]. 2987 48

We report a case of a 53-year-old woman with emphysematous pyelonephritis who presented the preservation of the ipsilateral kidney following open drainage. She was transferred to our hospital with chief complaints of right back pain and high fever. On diagnosis, diabetes mellitus and a stone in the right ureter were confirmed, and she was followed up at a local clinic. Computed tomography revealed the presence of gas in the right renal pelvis, and the stone led to right hydronephrosis. Additionally, her hemoglobin A1c level was 11.3%. Hence, we diagnosed the patient with emphysematous pyelonephritis. Although right percutaneous nephrostomy was performed immediately after her admission, the gas in the right renal pelvis extended to the renal parenchyma one day later. Therefore, we performed open drainage of the right kidney to control severe inflammation. The gas disappeared after the procedure, and her systemic status gradually improved. We hypothesize that emphysematous pyelonephritis is treated with open drainage instead of nephrectomy while preserving the ipsilateral kidney.
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PMID:[A CASE OF EMPHYSEMATOUS PYELONEPHRITIS WHO PRESENTED THE PRESERVATION OF THE IPSILATERAL KIDNEY FOLLOWING OPEN DRAINAGE]. 3230 82

We report on a 31-year-old male patient with non-invasive papillary urothelial carcinoma, low grade of the renal pelvis disguised as xanthogranulomatous pyelonephritis. The only symptom of the patient was lower back pain. The initial renal-enhanced computed tomography, magnetic resonance imaging and contrast-enhanced ultrasonography showed that the right kidney had a benign lesion and this inflammatory lesion might be xanthogranulomatous pyelonephritis. A percutaneous renal biopsy was performed and histopathologic examination revealed a xanthogranulomatous pyelonephritis. Initially, we diagnosed it as xanthogranulomatous pyelonephritis and treated it with antibiotics. One and a half years later, the patient suffered from back pain again. The lesion increased significantly and a right renal pelvic lesion with retroperitoneal lymphadenopathy was considered a malignant lesion on computed tomography scan. Therefore, radical resection of right renal pelvis carcinoma was performed under retroperitoneal laparoscopy. Intraoperative frozen section was reported as right renal urothelial carcinoma with no metastasis in renal hilar lymph node. Postoperative histopathologic examination revealed non-invasive papillary urothelial carcinoma, low grade of renal pelvis.
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PMID:Non-invasive papillary urothelial carcinoma, low-grade of the renal pelvis mimicking a xanthogranulomatous pyelonephritis in a male patient: A case report and review of literature. 3249 Jul 7

The patient was a 38-year-old man who had experienced nausea and fever for a few days and presented with back pain, oliguria, and pyuria, suggesting acute pyelonephritis (APN). He showed acute kidney injury (AKI) with bilateral kidney enlargement and was using nonsteroidal anti-inflammatory drugs (NSAIDs). AKI-induced by APN was confirmed by kidney biopsy. The AKI was successfully treated with antibiotic therapy. A search of the relevant literature for reports on histopathologically-proven APN-induced severe AKI revealed that the key characteristics were bilateral kidney enlargement with pyuria without casts. Oligoanuria was frequently associated with APN-induced severe AKI, and NSAID use may be a possible risk factor. Prompt antibiotic treatment based on the clinical characteristics of APN-induced AKI can improve the renal outcome.
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PMID:Pyuria without Casts and Bilateral Kidney Enlargement are Probable Hallmarks of Severe Acute Kidney Injury Induced by Acute Pyelonephritis - A Case Report and Literature Review. 3289 33


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