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 report the history of a 65-year-old woman, diabetic for 25 years who presented progressive alteration of consciousness with hyperthermia, right upper quadrant pain and vomiting. Bacteriological and radiographic investigations, especially computerized tomography scan of the abdomen, led to the diagnosis of emphysematous pyelonephritis caused by Escherichia coli. Despite a large spectrum antibiotic therapy and surgical drainage of the gas collection, the patient remained septic. An emergency nephrectomy was eventually performed. We review the characteristics of emphysematous pyelonephritis. Early diagnosis is essential because without early nephrectomy mortality rates reach 75%.
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PMID:[Emphysematous pyelonephritis in a diabetic patient. Literature review apropos of a case]. 164 35

Xanthogranulomatous cholecystitis (XGC) is a benign chronic inflammation of the gallbladder, rarely described in the radiologic literature. Like xanthogranulomatous pyelonephritis, it can clinically and radiologically mimic carcinoma. This unusual entity is characterized morphologically by a broad spectrum of xanthogranulomatous changes seen from a small limited focus within yellow nodule in the gallbladder wall, to diffuse involvement of the entire gallbladder with extension of the fibrosis into surrounding tissues. It is clear that recurrent inflammation and calculi are important for the pathogenesis, which is not well understood. The clinical presentation and radiologic findings of XGC are non specific. Irregular thickening of the gallbladder wall and local extension of the process can mimic carcinoma. Diagnosis of XGC is always established by histological examination, characterized by the infiltration of round cells, lipid laden histocytes and multinucleated giant cells in the muscle layer. We report a case of 76-year-old woman who had an episode of epigastric and right upper quadrant pain, 4 months before admission. Physical examination demonstrated a palpable mass in gallbladder region. Echography and computed tomography showed a large gallbladder, a thickened wall and an infiltration of the adjacent liver. The relatively well defined gallbladder internal border and the absence of biliary tract's dilatation allowed us to suggest the diagnosis of XGC, which was confirmed intraoperatively by frozen section histology. Once the diagnosis was established, cholecystectomy was performed. Occasionally, the inflammatory reaction is so severe that a subtotal cholecystectomy is required. Postoperative recovery was, as usually, uneventful. Although a rare entity, XGC should be considered in the differential diagnosis of complex right upper quadrant masses, as well as neoplastic gallbladder disease.
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PMID:[Preoperative diagnosis of xanthogranulomatous cholecystitis]. 747 80

The term biliary pseudolithiasis was coined by Schaad (1988) to describe the appearance of gallbladder sludge following treatment with ceftriaxone. After cessation of the drug the condition resolves, hence the term "pseudolithiasis." The third generation cephalosporin, cefatriaxone, is a very potent, broad spectrum antibiotic indicated in meningitis, osteomyelitis, pyelonephritis, Lyme disease and many other severe infectious diseases. Up to 46% of those receiving this antibiotic develop gallbladder sludge. Most are asymptomatic, but a small proportion may develop right upper quadrant pain, nausea, vomiting and even cholecystitis. Ultrasonography may demonstrate many, small, echogenic particles within the gallbladder, as well as larger echogenic foci casting acoustic shadows. However, it can not differentiate these pseudostones from real stones. There are reports of surgical intervention in such cases. 2 boys, aged 5 and 10 years, respectively, treated with ceftriaxone for meningitis are presented. Both developed symptoms during treatment and in both gallbladder sludge was identified by ultrasonography. In 1 intraluminal gallbladder findings were identical with the appearance of surgical stones. Follow-up ultrasonography after the drug was stopped showed no evidence of pseudostones in either case. Awareness of this phenomena might save many unnecessary operations.
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PMID:[Sonographic demonstration of pseudo-cholelithiasis after ceftriaxone]. 799 84

Fitz-Hugh-Curtis syndrome--inflammation of the liver capsule associated with genital tract infection--occurs in up to one fourth of patients with pelvic inflammatory disease (PID). Classically presenting as sharp, pleuritic right upper quadrant pain, usually but not always accompanied by signs of salpingitis, it can mimic many other common disorders such as cholecystitis and pyelonephritis.
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PMID:Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain. 1505 46