PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Pyelonephritis”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 667 records · Page 37Linked to original sources
PubMed1992

Multicenter open-label study of parenteral ofloxacin in treatment of pyelonephritis in adults.

The efficacy and safety of parenteral ofloxacin were evaluated in an open, multicenter study of hospitalized patients with pyelonephritis. The patients received ofloxacin 400 mg IV as an initial dose followed by ofloxacin 200 mg IV b.i.d. for a minimum of three days. The patients could then continue ofloxacin orally 200 mg b.i.d. for a total of seven to fourteen days. The most common pathogens isolated were Escherichia coli, Enterobacter cloacae, and Klebsiella pneumoniae. Microbiologic eradication was achieved in 65 of 66 evaluable patients (98%), and clinical cure or clinical improvement was noted in all patients. Of 82 patients evaluable for safety, 12 (15%) reported drug-related adverse events, the most frequent of which was pruritus or rash. None of the patients experienced drug-related central nervous system symptoms. Ofloxacin is well tolerated and highly effective in the treatment of pyelonephritis.

Administration, Oral↗
PubMed1984

Computed tomography differentiation of pyelonephritis and renal infarction.

Acute renal infarction and acute pyelonephritis can have identical clinical presentations. Most of the computed tomography findings seen in acute renal infarction are similar to those in acute pyelonephritis, except for the characteristic cortical rim sign seen in acute infarction. This finding differentiates these two disorders. This sign may be subtle and not appreciated unless searched for diligently with appropriate computed tomography imaging at varying window settings with particular attention to the subcapsular region.

Acute Disease↗
PubMed1995

Urinary secretory immunoglobulin A and free secretory component in pyelonephritis.

The immune defense mechanisms of mucosal surfaces involve secretory immunoglobulin A (sIgA) antibodies and, to a lesser degree, other specific and nonspecific immune factors. These antibodies are dependent on a secretory component (SC) for their transmission through the epithelium. This SC is also secreted without Ig as free SC (FSC). The kidney does produce these proteins; however, the ability of the lower urinary tract to secrete them has not been shown. Thus, an upper urinary tract infection should produce more urinary sIg and possibly more FSC than a lower tract infection. To demonstrate this, urine was obtained from normal controls (N = 33), cystitis patients (N = 22), and pyelonephritis patients (N = 27). Monoclonal antibodies binding to specific conformational epitopes were used in an enzyme-linked immunosorbent assay to detect the levels of sIgA and FSC in these groups. Previous sIgA measurements have been hampered by lack of specificity of the capture antibody. Urine creatinine was obtained to correct for the effect of diuresis. A one-tailed Student's t-test for nonparametric populations was performed to assess differences. The sIgA levels in the normal and cystitis groups were equivalent (1.4 micrograms/mg/mL and 1.3 micrograms/mg/mL, respectively; P = 0.32). When these two groups were compared with the pyelonephritis group (24.1 micrograms/mg/mL), a statistically significant difference was seen (P = 0.012 and P = 0.011, respectively), with no overlap. There was a statistical difference in the levels of FSC in these same groups, but a large degree of overlap.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

[Emphysematous pyelonephritis: diagnosis and treatment].

Emphysematous pyelonephritis is a necrotizing kidney infection characterized by the presence of gas in renal parenchyma, collecting system or perinephric tissue. This rare affection occurs almost exclusively in patients with diabetes mellitus and is due to non-anaerobic gas-producing bacteria. This life-threatening condition leads to septic shock and multiple organ failure. Diagnosis is suspected when a pyelonephritis does not respond to correct treatment, especially with altered vital signs or a diabetic patient. Computed tomography scan permits visualization of the gas and a radiologic classification with a prognostic value. Current treatment modalities are based upon repeated clinical and scanographic evaluations. In addition to systematic antibiotic therapy, percutaneous drainage is probably the first therapeutic stage in the majority of cases, but should not delay emergent rescue nephrectomy if necessary.

Anti-Bacterial Agents↗
PubMed2005

[Usefulness of procalcitonin for the diagnosis of acute pyelonephritis in children].

BACKGROUND: Acute pyelonephritis can induce parenchymal scarring. The aim of this study was to evaluate the usefulness of procalcitonin (PCT) to predict renal involvement in febrile children with urinary tract infection (UTI). METHODS: In a prospective study serum PCT was measured and compared with others commonly used inflammatory markers in children admitted to the emergency unit with acute pyelonephritis. Renal parenchymal involvement was assessed by a (99 m)Tc-labeled dimercaptosuccinic acid (DMSA) renal scar performed in the first 3 days after the admission. RESULTS: Among 42 enrolled patients, 19 (45%) had acute renal involvement (Group A) ; 23 (55%) (Group B) had normal DMSA scan (n = 16), or old scarring (n = 4) or various anomalies related to uropathy (n = 3). In group A, the mean PCT level was significantly higher than in the group B (5.4 ng/ml, vs 0.4 ng /ml, p < 10(-5)). In these 2 groups, mean C reactive protein (CRP) levels were 99.1 mg/l and 44.6 mg/l respectively (p < 0.001). For a level of serum PCT > or = 0.5 ng/ml, the sensitivity and specificity to predict the renal involvement were 100% and 87% respectively; for a level> or= 20 mg/l CRP had a sensitivity of 94% but a specificity of 30%. CONCLUSION: Serum PCT levels were significantly increased in febrile children with UTI when acute renal parenchymal involvement was present. PCT seems a better marker than CRP for the prediction of patients at risk of renal lesions.

Algorithms↗
PubMed2006

Severe emphysematous pyelonephritis on a horseshoe kidney.

Emphysematous pyelonephritis is an acute bacterial infection responsible for a high mortality. It is characterized by bacterial gas production in the renal parenchyma, occurring in diabetic patients in most case. The gold standard treatment has always been surgery associated with antibiotic therapy. We report the case of a 58 year-old woman, with undocumented diabetes, who presented with emphysematous pyelonephritis complicated with septic shock and acute renal failure. Antibiotherapy alone was successful.

Diabetes Complications↗
PubMed2006

Successful medical management of recurrent emphysematous pyelonephritis.

Emphysematous pyelonephritis is characterized by infection and gas formation in the renal parenchyma. This rare disorder tends to occur more frequently in patients with diabetes mellitus and urinary tract obstruction. In this case report, we describe a nondiabetic patient with Hinman syndrome who developed recurrent emphysematous pyelonephritis that was successfully treated with antibiotics on both occasions.

Anti-Bacterial Agents↗
PubMed2006

Effects of melatonin on suppression of renal scarring in experimental model of pyelonephritis.

OBJECTIVES: To determine the effects of melatonin combined with antibiotic administration on the suppression of renal scarring in an experimental pyelonephritis model. METHODS: The control group underwent a sham operation without infection. In the other groups, treatment began 72 hours after direct bacterial inoculation. In the no-treatment group, rats received daily intraperitoneal injections of saline. In the antibiotic-only group, the rats were treated only with ceftriaxone intramuscularly at a dose of 50 mg/kg once daily for 5 days. In the melatonin-only group, only 20 mg/kg of melatonin once daily was given by intraperitoneal injection for 5 days. In the antibiotic plus melatonin group, melatonin and ceftriaxone were administered at the same dosages and duration as for the single-modality treatment groups. After 6 weeks, the kidneys were removed for malondialdehyde measurements and histopathologic examination (inflammatory response and cicatrization). RESULTS: Melatonin only (134.25 +/- 13.42) and antibiotic plus melatonin treatment (122.62 +/- 8.91) caused a marked reduction in the mean malondialdehyde values compared with no treatment (214.12 +/- 17.77) and antibiotic-only treatment (161.37 +/- 16.03), with no significant difference compared with that of the control group (120.75 +/- 9.83). Histopathologically, in the no-treatment group, the severity of scarring correlated directly with the severity of inflammation (r = 0.93). No significant differences were found in the renal scarring scores in rats receiving no treatment and those treated only with antibiotic or melatonin. In the antibiotic plus melatonin treatment group, the cicatrization score was not statistically different from that of the control group. CONCLUSIONS: When combined with antibiotics, melatonin causes a significant inhibition of malondialdehyde production and neutrophil infiltration caused by acute pyelonephritis in an experimental rat model, and these are responsible for the protective effect of melatonin against renal damage, preventing renal scarring formation.

Animals↗
PubMed2003

[Emphysematous pyelonephritis: review of the literature concerning a case report].

Emphysematous pyelonephritis is defined as the presence of gas-producing bacteria in the kidney and in peri-nephretic areas. Even if it is rare, the mortality rate of this affection is between 50% and 90%. The E. coli is responsible in 60% of the cases. We report a case of a 50 years old male patient, with under diagnosed diabetics, how is admitted with pains in the left flank, fever, troubled urine, hematuria and worsening of general state. The diagnostic of emphysematous pyelonephritis was confirmed by CT Scan. In spite of adapted antibiotherapy to the renal function, insulinotherapy and correction of hydro-electrolytic troubles, the patient died with septic shock associated to digestive bleeding. Based on this case and a review of the literature, the authors describe the different features of this disease. Only an urgent nephrectomy after a short reanimation can improve the prognostic.

Diabetes Complications↗
PubMed2003

[Emphysematous pyelonephritis: radiologic diagnosis].

Emphysematous pyelonephritis (EPN) is a rare and severe form of acute pyelonephritis. Escherichia coli accounts for 60% of the cases. Predisposing factors are: diabetus mellitus, recent urinary tract infection and obstruction. There is a female predominance (2/1). Conventional radiography reveals the renal emphysema in 85% of the cases. Ultrasonography shows hyperechoic areas corresponding to the gaz. CT scan is the best technique, allowing the exact localization of the gaz inside the renal parenchyma. The natural course of the disease allows its radiologic classification in 4 grades. EPN has a poor prognosis if only a medical treatment is initiated. Every urinary tract infection, in a diabetic patient must be treated, and must lead to a radiologic exploration, which allows an early detection of severe forms of the disease.

Aged↗
PubMed1978

Experimental pyelonephritis induced by L-forms of Proteus mirabilis in rats.

Pyelonephritis was produced in 75 white rats by applying a 24-hour ligature on the ureter and by intravenous injection of a suspension of 5X10(9) cells of a stable Proteus mirabilis L-form. Pyelonephritis was proved microscopically in 44% of the animals. The revertants of the introduced L-form play an etiological role in the development of the infection. The stability of the pathohistological findings makes this model suitable for the purpose of experimental chemotherapy.

Animals↗
PubMed1994

Gas in hepatic veins: a rare and critical presentation of emphysematous pyelonephritis.

Although emphysematous pyelonephritis has been recognized for more than a hundred years, the actual etiology is still unknown. Glucose fermentation has been implicated as a mechanism of gas formation. We report a case of emphysematous pyelonephritis in which real-time ultrasonography demonstrated intravascular gas bubbles originating in the involved kidney, and passing into the inferior vena cava and hepatic veins. Gas from the affected kidney was analyzed by chromatography; the result showed hydrogen 10.5%, carbon dioxide 39%, nitrogen 49.6% and oxygen 0.8%. The clinical presentation and the results of gas analysis implicate a critical condition that bacteria proliferated rapidly by mixed acid fermentation of glucose. Additionally, the finding of gas production and transportation could explain the previous hypothesis of gas transport. In this critical situation immediate drainage with medical intervention is indicated to treat this life threatening condition.

Adult↗
PubMed1994

Xanthogranulomatous pyelonephritis in renal allografts: report of 2 cases.

We report 2 cases of xanthogranulomatous pyelonephritis that occurred in renal transplant recipients. Both cases were successfully treated with antibiotics. The traditional treatment of choice has been nephrectomy. No graft was lost as a result of xanthogranulomatous pyelonephritis and no nephrectomy was required in either patient. The course of these 2 patients is discussed and literature on this disease is reviewed.

Female↗
PubMed1994

Suppression of renal scarring by prednisolone combined with ciprofloxacin in ascending pyelonephritis in rats.

To prevent renal scarring, which occurs at the end stage of chronic pyelonephritis due to vesicoureteral reflux of infected urine, immediate antimicrobial treatment is reported to be essential. When treatment is delayed, the antimicrobial agent is believed to be effective only in eliminating bacteria, not in preventing scar formation. Using the ascending pyelonephritis model in rats, we investigated the effect of immediate or delayed treatment with ciprofloxacin and that of delayed treatment with a combination of ciprofloxacin and prednisolone in preventing renal scarring following infection. An inoculum of 1 x 10(9) colony forming units (cfu)/0.1 ml. of the HM32 strain of Escherichia coli, which was isolated from a patient with a urinary tract infection, was injected directly into the rat bladder, and the urethra was clamped for 4 hours in each rat. Treatment by ciprofloxacin (15 mg./kg., twice a day for 5 days) alone or in combination with prednisolone (2 mg./kg., once a day for 4 days) was initiated 6 or 72 hours after bacterial inoculation. The kidneys of each rat were examined 6 weeks later. Immediate treatment by ciprofloxacin significantly inhibited renal scarring (no scarring was seen in any of the 8 rats), but delayed treatment had no effect on scarring (4 of 8 rats showed scarring) when compared with the untreated controls (7 of 8 rats showed scarring). However, the addition of prednisolone to the delayed treatment with ciprofloxacin significantly inhibited renal scarring (only 1 of 10 rats showed scarring) when compared with the untreated controls (7 of 8 rats showed scarring). These data suggest that prednisolone is effective in preventing renal scarring which occurs due to vesicoureteral reflux when the initiation of antimicrobial treatment is delayed.

Animals↗
PubMed1993

Successful management of bilateral xanthogranulomatous pyelonephritis by bilateral partial nephrectomy.

Bilateral xanthogranulomatous pyelonephritis is a rare condition with 7 previously reported cases, all of which required dialysis and/or resulted in death of the patient. We report a case in which bilateral partial nephrectomy was performed successfully for bilateral xanthogranulomatous pyelonephritis. The etiology, symptomatology, radiographic findings and treatment of this rare inflammatory condition are discussed with a brief review of the previously reported cases.

Aged↗
PubMed1992

Pyelonephritis in male infants: how important is the foreskin?

We investigated the association of the uncircumcised foreskin and pyelonephritis in male infants less than 6 months old. During a 21-month prospective study 94 children (age range 2 weeks to 18.9 years) were hospitalized for febrile urinary tract infection. The male-to-female ratio for 35 patients less than 6 months old was 2.2:1. Of 59 patients older than 6 months the male-to-female ratio was reversed at 0.25:1 (p less than 0.001). In 13 of 24 infants (54%) less than 6 months old and in 8 of 12 boys (67%) older than 6 months a dimercaptosuccinic acid renal scan documented acute parenchymal damage (p = 0.72). Vesicoureteral reflux or other genitourinary abnormalities were found in only 3 of 24 patients (12.5%) less than 6 months old compared with 6 of 12 boys (50%) older than 6 months (p = 0.036). Of 24 infants less than 6 months old 22 (92%) were uncircumcised compared with 6 of 12 boys (50%) older than 6 months (p = 0.009). We then retrospectively compared the circumcision status of the infants who had febrile urinary tract infection with a control group of 63 infants matched for age, race and socioeconomic status hospitalized with febrile upper respiratory infection during a similar period. The frequency of uncircumcised infants in the control group with febrile upper respiratory infection was only 44% (28 of 63) compared with 91% of infants with febrile urinary tract infection (p less than 0.001). Overall the findings of the male predominance among patients less than 6 months old with febrile urinary tract infection, the disproportionately high frequency of infants with febrile urinary tract infection who were not circumcised, and the disproportionately low occurrence of vesicoureteral reflux and other genitourinary abnormalities in infants with febrile urinary tract infection strongly support an association between circumcision status and the risk for febrile urinary tract infection and pyelonephritis in male infants.

Acute Disease↗
PubMed1992

Vesicoureteral reflux and pyelonephritis in the monkey: a review.

P-fimbriated Escherichia coli, which cause nonobstructive pyelonephritis, adhere to a specific urothelial glycolipid receptor. In either the presence or absence of reflux (in the area of turbulent urine flow) these bacteria ascend the ureter and cause a decrease in ureteral motility. Endotoxin causes peristalsis to cease, leading to ureteral dilatation and change in papillary shape, thus allowing intrarenal reflux and adherence of the bacteria to renal tubules. Bacterial infection of a refluxing ureter may cause reflux to persist. Once the bacteria reach the kidney rapid effects occur at the cellular level with activation of complement followed by granulocytic aggregation and capillary obstruction, causing renal ischemia and damage during reperfusion. In addition, during phagocytosis the respiratory burst occurs, releasing toxic oxygen molecules, which leads to renal tubular death, invasion of the interstitium, microabscess and renal scar formation, that is chronic pyelonephritis, which equates with reflux nephropathy.

Animals↗