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)

Urinary tract infections (UTIs) are commonly encountered in medical practice and range from asymptomatic bacteruria to acute pyelonephritis. Enterobacteriaceae with E. coli being the most prevalent, are responsible for most commonly acquired uncomplicated UTIs and usually respond promptly to oral antibiotics. In contradistinction, more resistant pathogens cause nosocomially acquired infections which often require parenteral antibiotic therapy. Patients with acute bacterial prostatitis, usually caused by Enterobacteriaceae present with a tender prostate gland and respond promptly to antibiotic therapy. Chronic bacterial prostatitis on the other hand, is a subacute infection characterized by recurrent episodes of bacterial UTI where the patient presents with vague symptoms of pelvic pain and voiding problems. Treatment is protracted and may be frustrating. Nonbacterial prostatitis and chronic pelvic pain syndrome produce symptoms similar to those of chronic bacterial prostatitis. Treatment is not well defined due to their uncertain etiologies. Most episodes of catheter associated bacteruria are asymptomatic, where less than 5% will be complicated by bacteremia. The use of systemic antibiotics for treatment or prevention of bacteruria is not recommended, particularly in the geriatric age group, since it helps select for resistant organisms. Prevention thus remains the best option to control it. Few patients without catheters who have asymptomatic bacteruria develop serious complications and therefore routine antimicrobial therapy is not justified with only two exceptions : before urologic surgery and during pregnancy.
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PMID:Management of urinary tract infections. 1121 1

Fever, like metrorrhagia or pelvic pain, should be a danger signal alerting women with IUDs to seek medical attention without delay. If the temperature is elevated and the clinical signs suggest salpingitis or pelvic infalmmation, the patient should be hospitalized to obtain a diagnostic and therapeutic laparoscopy, intravenous polyantibiotic treatment, and bed rest. A temperature of about 38 degrees Celsius associated with metrorrhagia suggests salpingitis, regardless of other clinical findings, particularly if the patient is under 25, has had several sexual partners, is nulliparous, or is an insulin-dependent diabetic. The diagnosis should be confirmed by laparoscopy. If a virus or flu is as likely to be the cause as a gynecological infection, blood tests and assay of sedimentation rates should be obtained; over 10,000 polynuclear forms, mainly neutrophils, and a sedimentation rate elevated beyond that expected by the fever are significant in diagnosis. A sonogram can be used to rule out endometrial or tubal infection. If doubt persists, the IUD should be removed and a careful laparoscopy performed to assess the extent and nature of lesions. If the IUD is removed, effective replacement contraception should be prescribed. The physician should not ignore a fever in a patient using an IUD, and should be available for consultation immediately. Removal of the device without further treatment is insufficient in case of gynecological infection because of the danger posed to subsequent fertility. The IUD should not be removed without a short and intensive antibiotic treatment. The possibility of a partner with urethritis should not be ignored, and the fever should not be attributed to vaginitis, even if it is a severe case. The possibility of a pregnancy with the device in place should be ruled out. If the strings are not visible, a sonogram should be obtained to locate the device. In diagnosing febrile patients, the possibility of appendicitis and pyelonephritis should also be considered.
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PMID:[Dos...don'ts...in the case of unexplained high temperature in an IUD user (author's transl)]. 1233 2

Xanthogranulomatous (XG) prostatitis is a rare form of granulomatous prostatitis characterized by a benign inflammatory process of non-specific etiology that clinically may mimic carcinoma. Few cases have been reported in the English language medical literature, with only four reported cases presenting as prostatic abscesses. A 70-year-old male with type 2 diabetes mellitus and two previous kidney transplants presented with septic shock secondary to Pseudomonas aeruginosa bacteremia 4 days after undergoing a cystoscopy. Despite appropriate antimicrobial therapy, P. aeruginosa persisted in the blood for a total of 7 days. There were no indwelling prosthetic devices, no complicated pyelonephritis, and no endovascular sources of infection. Upon repeat clinical assessment, the patient reported pelvic pain. A digital rectal examination revealed prostatic tenderness and an endorectal ultrasound confirmed multiple prostatic abscesses. An ultrasound-guided transrectal needle aspirate drained scant purulent fluid and cultures grew the same phenotypic strain of P. aeruginosa. For definitive source control, the patient underwent transurethral resection of the prostate with unroofing of prostatic abscesses. The pathological findings were diagnostic of XG prostatitis. Given the rather acute presentation of this case, our hypothesis is that the prior urological instrumentation likely facilitated bacterial translocation and created the ideal environment for the development of pseudomonal prostatic abscesses resulting in XG inflammation and necrosis. XG prostatitis is a rare entity of uncertain etiology that can result in prostatic abscesses, and surgery is required for definitive diagnosis and management.
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PMID:Xanthogranulomatous prostatitis presenting as Pseudomonas aeruginosa prostatic abscesses: An uncommon complication after kidney transplantation. 3138 59

Haematogenous or direct spread of bacterial infection causing pelvic inflammatory disease of the upper female reproductive tract is uncommon. We report a diagnostically challenging case of a 41-year-old woman with a background of Stage 4 endometriosis presenting with fever, diarrhoea and abdominal pain with recent history of pyelonephritis. Initially managed for undifferentiated abdominal pain with unclear focus of infection, a broad range of investigations were undertaken. Laboratory samples confirmed the presence of Campylobacter jejuni and appropriate treatment for Campylobacteriosis was commenced. Despite treatment, her condition deteriorated and repeat radiological imaging revealed bilateral tubo-ovarian abscess requiring surgical drainage for control of severe sepsis. Sterile surgical samples of the abscess revealed Escherichia coli. This case adds to the growing body of evidence of the association between pelvic inflammatory disease, severe endometriosis and development of tubo-ovarian abscess. Sepsis associated with tubo-ovarian abscess has a mortality rate of up to 10%. Hence, we present this case to highlight severe endometriosis as a risk factor for disease and the need for prompt reassessment of the deteriorating woman with sepsis and pelvic pain to direct efforts to minimise morbidity and mortality.
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PMID:Concurrent Escherichia coli tubo-ovarian abscess and Campylobacter jejuni gastroenteritis: A case report. 3225 30