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)

We clinically evaluated the usefulness of a new oral antimicrobial agent, TFLX, in the field of urology. The dose administered was 150 mg t.i.d and the duration of administration was 3 days. The clinical effect was evaluated according to the criteria of the Japanese UTI committee. The clinical response obtained on 164 female patients with acute simple cystitis was excellent in 118, moderate in 44 and poor in 2 patients. The efficacy rate was 98.78%. The clinical response obtained on 4 male patients with acute simple cystitis was excellent in 2 and moderate in 2 patients. The efficacy rate was 100%. The clinical response obtained on 3 female patients with simple pyelonephritis was excellent in 2 and moderate in 1 patient. The efficacy rate was 100%. The clinical response obtained on one patient with non-gonococcal urethritis was excellent by doctor's evaluation. The clinical response obtained on 7 patients with complicated UTI was excellent in 3 and moderate in 4 patients. The efficacy rate was 100%. Three patients complained of stomach distress or malaise and 2 patients developed rash. No abnormal laboratory data were observed. Thus, TFLX appears to be safe and suitable for use in the field of urology.
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PMID:[Clinical studies on tosufloxacin (TFLX) in urology]. 152 27

An 11-year-old boy suffered from malaise, weight loss and pallor. A palpable abdominal tumor on the right side, anemia and increased C-reactive protein were detected. Intravenous urography revealed destruction of the right kidney resembling Wilms tumor. But ultrasound and computered tomography rised skepticism. Analysis of previously documented cases suggests that xanthogranulomatous pyelonephritis must equally be considered in a child with unilaterally enlarged kidney without function, especially when the child shows fever, leukocytosis, bacteriuria, anemia, leukocyturia, calculi of the urinary tract, abdominal pain and/or a palpable abdominal tumor. Ultrasound and computered tomography can lead to the diagnosis, and identify extrarenal infiltration. Nephrectomy results in complete cure and is therefore the treatment of choice.
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PMID:[Xanthogranulomatous pyelonephritis]. 302 38

A clinical study was performed in 13 cases of refractory Enterococcus faecalis pyelonephritis that were detected in the Department of Urology, Hiratsuka Municipal Hospital, from April 1975 to March 1995. The characteristic features were that pyelonephritis was commonly seen in females, and clinical symptoms (low-grade intermittent fever, low back pain, general malaise, etc.) were continuously refractory. Bacteriuria or polymicrobial infections were often found, and bacterial count was often as high as 10(2)-10(4)/ml. Nevertheless we considered that E. faecalis caused of refractory pyelonephritis must not have week adherence and pathogenesis to the kidney, owing to the clinical symptoms and the basic subjects. Furthermore this infection was difficult to cure completely with antimicrobials having activity against E. faecalis, and long-term treatment was needed. Therefore, we recommend that treatment for refractory E. faecalis pyelonephritis be carefully selected according to clinical symptoms and the bacterial density of this strain.
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PMID:[Characteristic clinical features of pyelonephritis caused by Enterococcus faecalis]. 861 86

Xanthogranulomatous pyelonephritis is an uncommon variant of chronic pyelonephritis that predominantly affects middle-aged women. Patients usually present with fever, back or flank pain, flank mass, and the constitutional symptoms of fatigue, malaise, weight loss, and anorexia. Rarely, they may present with a draining sinus. There is usually a history of urinary tract infection, obstruction, or instrumentation. Other abnormalities include anemia, leukocytosis, abnormal liver enzymes, pyuria, and hematuria. Mild azotemia may be present, but frank renal failure is rare. Urine and renal tissue cultures are frequently positive. The most commonly isolated bacterial pathogens are P. mirabilis and E. coli, but other organisms have also been implicated. A CT scan is the best radiologic imaging technique to discover the extent of inflammation as well as any involvement of adjacent structures. Lipid-laden macrophages called xanthoma cells characterize the disease at the microscopic level. Nephrectomy is curative. Careful preoperative evaluation will guide surgical planning in choosing an approach that provides adequate exposure of the affected tissue and facilitates subsequent care of the patient.
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PMID:A middle-aged woman with back and flank pain. 881 29

The transient presence of infiltrated leukocytes in the kidney during acute renal failure as well as the location of these cells within the renal interstitium suggest their association with tubular injury and/or regeneration. To date, however, neither a positive nor a negative contribution of these cells to the pathophysiology of this disease could be unambiguously demonstrated. Ill-defined methods for identifying interstitial leukocytes have added to the controversy concerning the role of inflammatory cells in renal regeneration. The current literature survey presents a qualitative description of the renal interstitial accumulation of leukocytes as observed in some acute renal failure models, with special attention to those displaying acute tubular necrosis of particular nephron subsegments. We conclude that lethal or sublethal injury to renal tubular epithelial cells following toxic or ischemic insults leads to the manifestation of an interstitial mononuclear cell infiltrate. Whereas macrophages and T lymphocytes almost invariably take part, the former being the dominant cell population with respect to both magnitude and presence over time, polymorphonuclear cells seem to be significantly increased only in the case of pyelonephritis. Infiltrating cells have often been regarded rather harmful to the tissue, mainly due to the quite well understood injuring capacity of the latter. On the other hand, we speculate mononuclear leukocytes through their potential of producing different cytokines and growth factors (FGF, TGF-alpha, EGF-like, IL-2, etc.) might well play an initiating and mediating role in renal regeneration after acute tubular necrosis. Therefore, the role of infiltrating leukocytes in the injury/regeneration process during acute renal failure remains highly controversial and should be further elucidated.
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PMID:Regeneration processes in the kidney after acute injury: role of infiltrating cells. 980 21

The patient was a 77-year-old man who underwent radical cystectomy and ileal conduit urinary diversion due to bladder cancer in 1989. A stenosis of the right uretero-ileal anastomosis occurred in 1992, and of the left uretero-ileal anastomosis in 1999. These were treated with indwelling of a ureteral stent and percutaneous nephrostomy, respectively. He was admitted to our hospital for progressive renal dysfunction due to frequent pyelonephritis. We performed a reconstruction of the ileal conduit urinary diversion and after the removal of the bilateral ureteral stent he complained of nausea and general malaise. The laboratory data showed hyponatremia, hyperkalemia and azotemia, which were diagnosed as complication liked jejunal conduit syndrome. He was treated with hydration and salt supplementation. With regard to this case, we considered that a long ileal conduit close to the jejunum and renal dysfunction caused the complication liked jejunal conduit syndrome. Careful observation and follow-up laboratory examination should be performed if the patient has renal dysfunction and a long conduit near the jejunum is used for the ileal conduit.
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PMID:[A case report of complication liked jejunal conduit syndrome induced by reconstruction of ileal conduit]. 1510 28

Xanthogranulomatous pyelonephritis (XGPN) is a rare, severe and atypical form of chronic pyelonephritis. It is characterised by destruction of the renal parenchyma and replacement with a chronic inflammatory infiltrate and lipid-laden macrophages resulting in a non-functional kidney. The authors report a case of a 5-year-old boy presented with a history of abdominal pain, malaise, anorexia and weight loss for 2 months. Physical examination revealed a large flank mass and the child was directed to the oncology unit on suspicion of renal tumour. Based on clinical examination and imaging, the presumptive diagnosis of XGPN of the left kidney was made. A left transperitoneal nephrectomy was performed and the histology confirmed the diagnosis. Although rare, XGPN is a clinically important entity that should be considered in the differential diagnosis of an atypical-appearance renal mass in paediatric age.
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PMID:Xanthogranulomatous pyelonephritis presenting as a pseudotumour in a 5-year-old boy. 2323 19

Xanthogranulomatous pyelonephritis (XGP) is a rare entity and constitutes less than 1% of chronic pyelonephritis. A 71-year-old male was introduced to our department with general malaise and abnormal findings of computed tomography (CT). Abnormal findings of complete blood count and laboratory examination included an elevated WBC count and C-reactive protein. Urinalysis showed combined hematuria and pyuria, and Escherichia coli was detected in urine culture. Abdominal CT revealed left hydronephrosis with staghorn renal calculi and thin cortex of the left kidney. Because of poor condition, the patient underwent construction of the left nephrostomy. After that, the remission of the inflammation was achieved. Several months after the construction, frequent obstructions of nephrostomy catheter because of turbid urine and intermittent fever elevation were observed. The patient and his family desired left nephrectomy despite his poor condition in general. Surgical dissection was very difficult due to fixed mass. Not long after that the patient died due to sepsis and cardiovascular failure. Microscopic findings of the left kidney revealed infiltration of lymphocytes and lipid-laden macrophages (xanthoma cells) corresponding to XGP.
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PMID:Case of the diffuse form of xanthogranulomatous pyelonephritis. 2336 80

A 32-year-old female presented to us with worsening cough and expectoration, low-grade fever, and malaise for 3 months. She gave a history of pregnancy loss secondary to urinary tract infection (UTI) a year back. At that time, she was told to have an obstructive right renal calculus. She also had a history of recurrent UTI in the past 1 year. She had no other comorbidities. Her clinical evaluation revealed an enlarged right kidney and reduced air entry in the right hemithorax. Radiological investigations revealed a large right kidney invading into the inferior surface of the right lobe of the liver and the right pleural space. A clinical diagnosis of xanthogranulomatous pyelonephritis was made, and she was advised nephrectomy. Intraoperatively, the right kidney was found to invade both the right lobe of the liver and the right pleural cavity through a right diaphragmatic defect. Histopathology of the kidney revealed the presence of foamy histiocytes suggestive of xanthogranulomatous pyelonephritis. Invasive xanthogranulomatous pyelonephritis is known, however, invasion into the extra-abdominal structures has not been reported in the literature. Our case is a rare manifestation of a rare clinical entity - xanthogranulomatous pyelonephritis.
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PMID:Xanthogranulomatous Pyelonephritis: Intrahepatic and Intrathoracic Extension. 3064 3

A 49-year-old male with untreated diabetes mellitus type 2 experienced eyesight deterioration and general malaise, and was treated for uveitis and orbital cellulitis. Later, he was taken to a local hospital via ambulance for a consciousness disorder and was diagnosed with bilateral infectious endophthalmitis, a right ureteral stone, and emphysematous pyelonephritis. He was then referred to our hospital for further examination and treatment. We immediately initiated intravenous antibiotic therapy with meropenem and glycemic control with continuous subcutaneous insulin infusion, and placed a ureteral and percutaneous drain tube into the right ureter and the emphysema, respectively. We performed a diagnostic and therapeutic vitrectomy on the patient's left eye. Urinary, blood, and vitreous cultures were positive for Klebsiella aerogenes. Abdominal contrast-enhanced computed tomography showed bilaterally comparable renal contrast enhancement. On the 60th hospital day, we performed endoscopic combined intrarenal surgery (ECIRS) and completely removed the urinary stone. Although he lost light sensitivity in his right eye, his left eyesight improved, and his blood glucose level was adequately managed by oral medication. Three months after the surgery, he was discharged from our hospital and he showed no sign of recurrence of the infection at ten months after surgery.
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PMID:[A Case of Emphysematous Pyelonephritis Complicated by Bacterial Endophthalmitis in which Multidisciplinary Therapy Led to Preservation of the Kidney]. 3327 55


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