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At least 685 records · Page 38Linked to original sources
PubMed1989

Xanthogranulomatous pyelonephritis and amyloidosis: a rare association.

The coincidence of systemic amyloidosis and xanthogranulomatous pyelonephritis has been reported previously only once. Clinical findings, such as the nephrotic syndrome, cardiac and autonomic nervous system dysfunction, and adrenal insufficiency, are suggestive and a thorough investigation to rule out other causes of secondary amyloidosis is warranted. We report a case of xanthogranulomatous pyelonephritis associated with secondary systemic amyloidosis and the nephrotic syndrome. Treatment consisted of nephrectomy and intensive supportive care. The unique clinical, radiographic and pathological aspects of this case are discussed.

Amyloidosis↗
PubMed1990

Computerized tomography in acute pyelonephritis: the clinical correlations.

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.

Blood Sedimentation↗
PubMed1988

Xanthogranulomatous pyelonephritis in a renal allograft.

We report a case of xanthogranulomatous pyelonephritis in a cadaver kidney allograft. The patient had diabetic glomerulosclerosis. The predisposing factors that led to this condition included hyperglycemia, a previous rejection reaction and Escherichia coli urinary infection. Persistent fever, pyuria, bacilluria and a nonfunctioning allograft resulted in allograft nephrectomy. The diagnosis was made on histological examination. Diagnostic criteria for xanthogranulomatous pyelonephritis in the allografted kidney are similar to those in the native kidney.

Adult↗
PubMed1985

Therapy of symptomatic pyelonephritis in women.

A prospective randomized controlled study was performed on 44 women with community-acquired, uncomplicated pyelonephritis requiring hospitalization. The study was designed to determine if an extended course of therapy (21 days) would be more effective than the conventional 10-day course of therapy. All patients initially received either gentamicin or tobramycin parenterally for 48 to 72 hours, and then were prescribed an oral agent that possessed in vitro inhibitory activity for the urinary pathogen to complete the course of therapy. Duration of medication was assigned according to a table of random digits. Of the 22 women receiving the 10-day treatment 17 were cured, 4 experienced a reinfection and none had a relapse, compared to 12, 5 and 3, respectively, of 22 receiving the 21-day treatment. Analysis of the therapeutic failures did not demonstrate any superior response for either treatment program (p less than 0.75 and greater than 0.50). No statistically increased incidence of adverse drug reactions occurred in patients receiving the extended course of therapy. Our data do not support an extended course of therapy in women with acute symptomatic pyelonephritis uncomplicated by structural abnormalities.

Adolescent↗
PubMed1984

Atypical presentation of xanthogranulomatous pyelonephritis: diagnosis by ultrasonography and fine needle aspiration biopsy.

The diagnosis of xanthogranulomatous pyelonephritis may be difficult to make preoperatively. We describe a patient who had a nonfunctioning kidney with a normal collecting system on retrograde pyelography as well as normal angiography and venography. Preoperative diagnosis was xanthogranulomatous pyelonephritis by fine needle aspiration biopsy under ultrasonic guidance.

Adult↗
PubMed1983

Pyelonephritis from severe incrustations on silicone ureteral stents: management.

We report an unusual case of pyelonephritis secondary to large incrustations on silicone double J ureteral stents left indwelling for 12 months. After the pyelonephritis was treated with antibiotics, hemiacidrin irrigation via percutaneous nephrostomy tubes and a ureteral stent was used to dissolve the incrustations and allow removal of the stents.

Aged↗
PubMed1982

Clinical studies in acute pyelonephritis: is there a place for renal quantitative camera study?

We evaluated 27 patients with presumed acute pyelonephritis. The clinical criteria included flank pain, fever, bacteriuria and leukocytosis. When compared to excretory urograms renal scintillation camera studies confirmed the diagnosis in 19 patients, including 5 with normal excretory urograms, and disproved it in the remaining 8. This radionuclide study was found to be more precise. If the study is normal the diagnosis of pyelonephritis is excluded and further studies are not needed.

Acute Disease↗
PubMed1982

Immunology of pyelonephritis in the primate model. V. Effect of superoxide dismutase.

Ascending acute pyelonephritis was produced in monkeys by infusion of bacteria through a ureteral catheter to the point of intrarenal reflux. This led to a significant inflammatory response with death of renal tubular cells in the area of the tubular granulocytes and bacteria. We gave superoxide dismutase, and found that the inflammatory response was decreased and fewer tubular cells were killed. Ultrastructural change was also decreased in tubular cells adjoining phagocytosing neutrophils. This suggests that renal damage following a bacterial infection may be due to the production and release of superoxide into the tubular lumen during phagocytosis. We believe that it is the initial event which may lead to the eventual loss of renal tissue and function called chronic pyelonephritis.

Animals↗
PubMed1981

Emphysematous pyelonephritis in a solitary kidney.

A middle-aged female diabetic presented with ureteral obstruction, renal failure and emphysematous pyelonephritis in a solitary kidney. She was treated non-operatively with intensive antimicrobial therapy, prolonged ureteral catheter drainage and dialysis. Good recovery of renal architecture and function was eventually obtained. Although the usual indications for surgical extirpation or drainage of the kidney with emphysematous pyelonephritis seem to be well established circumstances may occasionally dictate an alternative course of action.

Diabetic Nephropathies↗
PubMed1980

Xanthogranulomatous pyelonephritis associated with renal carcinoma.

The first case of xanthogranulomatous pyelonephritis associated with renal carcinoma is reported. Differentiation of the 2 entities clinically may be difficult and, since treatment regimens recommended in the past have included partial nephrectomy in cases of limited xanthogranulomatous pyelonephritis, one must hereafter be aware of such a combination when considering such a therapeutic modality.

Granuloma↗
PubMed1977

Emphysematous pyelonephritis.

Emphysematous pyelonephritis is an uncommon infection of the renal parenchyma found most often in diabetic patients. The fortieth case of emphysematous pyelonephritis is reported and a plan for management is proposed based on differentiating this condition from gas-forming infections of the perinephric space and the renal collecting system.

Air↗
PubMed1976

Nephrotic syndrome secondary to chronic pyelonephritis and ureterovesical reflux.

Vesicoureteral reflux and chronic pyelonephritis are usually associated with proteinuria of less than 1 gm. per 24 hours. When there is massive proteinuria an associated glomerulopathy is usually present. We describe a patient who had nephrotic syndrome with radiological evidence of ureterovesical reflux and histological evidence of chronic pyelonephritis without associated glomerulonephritis.

Adolescent↗
PubMed2001

Xanthogranulomatous pyelonephritis associated with a congenital caliceal diverticulum.

We report a rare case of xanthogranulomatous pyelonephritis occurring in a caliceal diverticulum in a 1-year-old child. She presented with recurrent urinary tract infections. A computed tomography scan demonstrated an enhancing cystic lesion in the left kidney. At open exploration, a caliceal diverticulum was found with a very stenotic opening into the renal pelvis. The diverticulum was enucleated, and the pathologic examination confirmed xanthogranulomatous pyelonephritis in the parenchyma surrounding the diverticulum. The child did well postoperatively with no recurrence of her urinary tract infections.

Diverticulum↗
PubMed1998

Levofloxacin versus ciprofloxacin versus lomefloxacin in acute pyelonephritis.

OBJECTIVES: To evaluate, in two randomized, multicenter trials, levofloxacin compared with ciprofloxacin and lomefloxacin for efficacy and safety in treating acute pyelonephritis. METHODS: We enrolled a total of 186 patients with bacteriologically proved infection. Of these, 89 patients in both trials combined received levofloxacin 250 mg once daily; 58 received ciprofloxacin 500 mg twice daily in the first trial (double blind); and 39 received lomefloxacin 400 mg once daily in the second trial (open label). Microbiologic response of patients evaluable for microbiologic efficacy was the primary efficacy variable, and clinical response of microbiologically evaluable patients was the secondary efficacy variable in both studies. RESULTS: Escherichia coli was the most prevalent pathogen. At 5 to 9 days after the end of treatment, 95% of uropathogens were eradicated in patients who received levofloxacin compared with 94% in the ciprofloxacin-treated group and 95% in the lomefloxacin-treated group. The clinical cure rate was 92% for levofloxacin in both studies combined, 88% for ciprofloxacin, and 80% for lomefloxacin. Drug-related adverse events were reported by 2% of levofloxacin-treated patients, 8% of ciprofloxacin-treated patients, and 5% of lomefloxacin-treated patients. CONCLUSIONS: The once-daily oral administration, proven efficacy, and good tolerability make levofloxacin an excellent choice for empiric treatment of acute pyelonephritis.

Acute Disease↗
PubMedDate not supplied

Mannose-resistant haemagglutination and P antigen recognition are characteristic of Escherichia coli causing primary pyelonephritis.

Thirty-two Escherichia coli strains from 30 children with pyelonephritis were examined for their haemagglutination patterns and O and K serotypes. 29 (91%) of the strains showed mannose-resistant haemagglutination (MRHA). By use of well-defined target cells, these MRHA+ strains could be shown to recognise human cells either in a P-specific manner (recognising a specific galactosyl-galactose structure which is part of P blood groups antigens) or in a separate, X-specific manner. Both recognition mechanisms could occur separately or together on the same bacteria, the frequencies of P and X specificity being 81 and 19%, respectively. Both MRHA and P specificity were significantly associated with the O antigens 01, 04, 06, 016, and 018, and the capsular antigen K1, which have previously been associated with pyelonephritis. However, the association of MRHA and P specificity with upper urinary tract infection in children is greater than that of any other laboratory-defined bacterial characteristic.

Antigens, Bacterial↗