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

During the last 20 years 500 girls with recurrent urinary tract infection and documented reflux were seen in private practice. All patients received medical treatment for 3 to 48 months (an average of 15 months) after which the 250 who were not cured underwent a corrective operation. The primary reason for an antireflux operation is to protect the kidney from the damaging effect of a combination of high pressure and infection. Thus, the criteria for operation included persistent infection, renal changes typical of previous pyelonephritis, major reflux and abdominal or flank pain. The surgical cure rate after careful long-term followup approaches 98%. The medical cure rate at the end of 2 years reached 88%. This experience has enabled the establishment of a rigorous point system, providing common denominators regarding indications for operation. It emphasizes the desirability of attempting a medical cure for at least 1 year after urethral dilatation, except when major orifice defects and major reflux exist. This system should help to increase communication and coordination of efforts among the pediatrician, radiologist and urologist.
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PMID:Treatment of vesicoureteral reflux: point system based on 20 years of experience. 57 83

Acute lobar nephronia, or focal pyelonephritis, is an uncommon form of renal infection with a distinct computerized tomographic appearance. A patient is presented with lobar nephronia characterized by fever, flank pain, urosepsis, and painful abdominal mass. Differentiating this condition from abscess or other renal mass is important, because the treatment of lobar nephronia is nonsurgical. The infection responds to antibiotic therapy.
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PMID:Case report: acute focal bacterial pyelonephritis (lobar nephronia)--presentation as a palpable abdominal mass. 144 71

The present study demonstrates that renal tubular unresponsiveness to aldosterone, without associated hyperkalaemia, is present in children with acute pyelonephritis. We studied 32 children with a diagnosis of acute pyelonephritis established by high fever, flank pain/tenderness, increased blood levels of C-reactive protein and significant Escherichia coli growth in the urine culture. Renal tubular function tests and determinations of plasma renin activity and aldosterone concentration were performed at diagnosis (study 1), after three days of iv gentamycin (study 2) and after 21 days of antibiotic therapy (study 3). Findings were compared to those present in 32 normal children of similar age. Despite normal plasma potassium concentration, fractional potassium excretion and transtubular potassium concentration gradient were significantly decreased in studies 1 and 2, becoming normal in study 3. Decreased renal potassium excretion coexisted with increased values for plasma renin activity and aldosterone concentration. In study 3 these hormones remained elevated only in patients with scarred kidneys. The functional alteration present in acute pyelonephritis may be directly caused by the interstitial inflammation or be mediated by some E. coli endotoxin.
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PMID:Normokalaemic pseudohypoaldosteronism is present in children with acute pyelonephritis. 149 6

A retrospective study of 36 patients with xanthogranulomatous pyelonephritis who underwent nephrectomy at our hospital was performed. The disease occurred most frequently in middle-aged women with a history of recurrent urinary tract disorder. There were 2 cases of focal xanthogranulomatous pyelonephritis, 2 associated with emphysematous pyelonephritis, 2 that manifested as fistula formation between the colon or skin, and 1 with deep sinus formation into the hip joint that presented as septic arthritis. Flank pain and fever were the most frequent complaints. Escherichia coli (67%) and Proteus mirabilis (26%) were the most common organisms isolated from the voided urine, kidney and blood stream. Cephalothin plus gentamicin or tobramycin were the drugs of choice before surgical intervention.
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PMID:Xanthogranulomatous pyelonephritis: experience in 36 cases. 173 87

The diagnosis of pyelonephritis is based on clinical and laboratory criteria that include fever, flank pain or tenderness, leukocytosis, pyuria, and confirmatory urine culture. A Gram stain of unspun urine can provide an important early clue regarding the etiologic agent. At least 85% of cases are caused by Escherichia coli, but clinicians need to be aware of other potentially aggressive organisms as well. Elderly, diabetic, or immunocompromised hospitalized patients and patients subject to instrumentation present a more complex diagnostic challenge and require more intense parenteral treatment. Prompt diagnosis and proper therapy decrease the risk of serious complications.
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PMID:Acute pyelonephritis. Preventing complications through prompt diagnosis and proper therapy. 173 45

A 51-year-old male patient with diabetes mellitus consulted his home doctor because of high fever and right flank pain. Urinalysis showed marked pyuria. Treatment with antibiotics was not completely effective, and he was referred to our hospital for further examination and treatment. CT scan showed an abnormal gas shadow in right renal parenchyma. He was diagnosed with emphysematous pyelonephritis and right subcapsular nephrectomy was done after the control of diabetes mellitus. We reviewed 57 cases of emphysematous pyelonephritis including our case in the Japanese literature, and we discussed about its etiology, symptomatology, choice of treatment and prognosis.
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PMID:[A case report of emphysematous pyelonephritis]. 218 91

Computerized tomography was performed on 19 patients diagnosed as having uncomplicated acute pyelonephritis. The relationship was investigated among the laboratory findings, presence of flank pain, clinical course and severity of the lesions detected by computerized tomography. In patients febrile for less than 2 weeks healing as assessed by computerized tomography took an average of 76 days. However, in patients with repeated febrile episodes occurring for longer than 2 weeks healing was delayed until an average 232 days after onset. Computerized tomography findings generally correlated well with the erythrocyte sedimentation rate, C-reactive protein level, and presence of pyuria and flank pain. However, in patients with a prolonged course computerized tomography proved to be a more reliable indicator of progress than either the results of laboratory tests or the symptoms. In conclusion, computerized tomography was useful in the diagnosis, assessment of severity and evaluation of healing of acute pyelonephritis.
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PMID:Computerized tomography in acute pyelonephritis: the clinical correlations. 238 15

A 36-year-old woman with diabetes mellitus complained of left flank pain and high fever. Drip infusion pyelogram (DIP) did not visualize the left kidney, but revealed crescent-shaped gas formation within the left renal shadow. Abdominal computerized tomography showed a subcapsular shadow in the left kidney. Because her symptoms was aggravated, left nephrectomy was performed under the diagnosis of emphysematous pyelonephritis. There was no manifestation of her prior symptoms after the operation, and she was discharged on the 19th postoperative day. In Japan, 43 cases of emphysematous pyelonephritis have been reported in the literature. These 43 cases were studied clinically and in comparison to the cases reported in Western countries. The male-to-female ratio was approximately 4 to 1, in contrast to the Western ratio of female preponderance. The age of the patients showed its peak at the 50-60's, the mean age being not significantly different from that of Western patients. 37% of the patients had the affected side on the right, 56% on the left, and 7% bilaterally. This was comparable to the results of Western countries. 93% of the subjects suffered from diabetes mellitus as the basal malady, which was comparable to that in Western studies. However, patients afflicted with urinary passage impairment accounted for 14%. This incidence was lower than that reported in Western studies.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Emphysematous pyelonephritis a case report and review of the literature--comparative study with Japan and other countries]. 266 95

A case of right pyelonephritis with hydronephrosis complicating relapsing acute pancreatitis and right pararenal phlegmon formation is presented. Hydronephrosis is a reportedly rare complication of extrapancreatic inflammation; the only 6 previous cases involving the right side are reviewed. The present case report, to our knowledge, is the first to describe clinical and laboratory evidence of pyelonephritis secondary to partial obstruction of the right upper renal tract by an extrapancreatic phlegmon. The clinician caring for patients with acute pancreatitis should be aware of this important complication, since the presentation of pyelonephritis-flank pain and fever--could erroneously be attributable solely to the pancreatitis.
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PMID:Pyelonephritis complicating relapsing acute pancreatitis. 266 64

A case of blind-ending bifid ureter is presented. A 65-year-old man was admitted with the complaint of dysuria. He had no past episode of left flank pain or pyelonephritis. Digital examination and urethrography suggested benign prostatic hypertrophy. Drip infusion pyelography showed an abnormal cavity at the lower portion of the left ureter. He was diagnosed as benign prostate hypertrophy and left blind-ending bifid ureter. During suprapubic prostatectomy, the bifid ureter was resectd. The related reports are reviewed in the Japanese literature.
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PMID:[Blind-ending bifid ureter: report of a case]. 269 42


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