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Results for “Pyelonephritis”

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PubMed1985

Urinary immunoglobulins in healthy individuals and children with acute pyelonephritis.

Urine samples obtained from children with acute pyelonephritis and from healthy children and adults were analysed with regard to the molecular form and specific antibody activity of urinary immunoglobulins. The urinary IgA and IgG levels were quantified in unconcentrated urine by radioimmunoassay. The children with urinary tract infection had significantly higher levels of IgG and IgA than age-matched controls but not higher than healthy adults. After tenfold concentration, the urine was fractionated on an Ultrogel AcA 22 column, and the IgA, secretory IgA, and IgG in the fractions were determined by radioimmunoassay. IgA in urine from healthy adults was predominantly represented by polymeric IgA linked to secretory component; small quantities of monomeric IgA were also present. IgG eluted in the position of the serum standard. Increased proportions of IgG and monomeric IgA were found in the infected patients. Specific antibody activity of the IgG and IgA classes to antigens of the infecting Escherichia coli strain was detected in whole and in fractionated urine from children with acute pyelonephritis. The specific antibody activity in healthy adults and children was low.

Acute Disease↗

PubMed1995

Renocolic fistula caused by xanthogranulomatous pyelonephritis.

A 68-year-old female was diagnosed with a renocolic fistula, associated with left chronic pyelonephritis due to a ureter stone. Nephrectomy and repair of the fistula were performed. Histopathological examination revealed xanthogranulomatous pyelonephritis.

Aged↗

PubMed2005

Diffuse xanthogranulomatous pyelonephritis in a patient with myotonic dystrophy and cerebral palsy.

Xanthogranulomatous pyelonephritis (XGP), a morphological and clinical variant of chronic pyelonephritis, is an uncommon disease in children. It is characterized by the destruction of the renal parenchyma and replacement by granulomatous tissue containing foamy lipid-laden macrophages and is classified into diffuse and focal XGP. We present a case of diffuse XGP in a child with myotonic dystrophy complicated by cerebral palsy and discuss the importance of correct diagnosis and preoperative management to reduce inflammation and improve malnutrition associated with the disease.

Adolescent↗

PubMed2006

Xanthogranulomatous pyelonephritis with a renocolic fistula caused by a parapelvic cyst.

Fistula formation between the upper urinary tract and bowel is an uncommon complication in urogenital diseases. We present a rare case of focal xanthogranulomatous pyelonephritis with a renocolic fistula. This is the first case where a parapelvic cyst obstructs the caliceal outflow and leads to the formation of a renocolic fistula in renal inflammatory disease. It is difficult to make a preoperative diagnosis of focal xanthogranulomatous pyelonephritis with widespread involvement that is caused by non-calculous urinary tract obstruction.

Colonic Diseases↗

PubMed1988

Candida pyelonephritis complicated by fungaemia in obstructive uropathy.

Fungal pyelonephritis caused by Candida species and Torulopsis without evidence of systemic organ involvement is uncommon. Most reported cases have been in diabetic females or in patients on immunosuppressive drugs. We report 3 cases of elderly men who had fungal pyelonephritis presumed secondary to obstructive uropathy. All subsequently developed fungaemia. Two were managed successfully with percutaneous or ureteric stents and systemic antifungal therapy; the third died despite systemic amphotericin B.

Aged↗

PubMed1990

Emphysematous pyelonephritis: surgical implications.

Emphysematous pyelonephritis in patients with diabetes mellitus is increasingly recognised as a disease requiring urgent and aggressive treatment. We present 3 cases of emphysematous pyelonephritis; 1 patient required percutaneous nephrostomy followed by nephroureterectomy but the other 2 were successfully managed with antibiotics and control of diabetes. Diagnosis was confirmed by sequential imaging techniques which demonstrated an inflammatory renal mass associated with gas and fluid.

Cefotaxime↗

PubMed1993

Emphysematous pyelonephritis: a case report and review of the literature.

Emphysematous pyelonephritis is a rare and life-threatening suppurative infection of renal parenchymal and perirenal tissues, characterized by spontaneous gas production. Although uncommon (76 cases in the literature), it occurs almost exclusively in diabetic patients (87% of the cases). We describe a recent case of a diabetic woman with emphysematous pyelonephritis due to E. coli, successfully managed with unilateral nephrectomy. Symptoms, diagnostic approach and management are discussed and related to the previously reported series.

Aged↗

PubMed2005

Toll-like receptor-4: renal cells and bone marrow cells signal for neutrophil recruitment during pyelonephritis.

BACKGROUND: The molecular mechanisms of pathogen recognition that initiate infective pyelonephritis are poorly understood. Toll-like receptor-4 (TLR4) mutant mice infected with uropathogenic Escherichia coli lack renal CXCL2 mRNA expression, subsequent neutrophil recruitment, and renal abscess formation. METHODS: We used a bone marrow transplant approach in order to investigate the contribution of TLR4 in intrinsic renal cells or bone-marrow-derived immune cells to neutrophil recruitment during infective pyelonephritis. RESULTS: Both chimera either expressing mutant tlr4 in intrinsic renal cells and wild-type tlr4 in bone marrow-derived cells or vice versa showed an impaired response to uropathogenic E. coli infection in terms of leukocyturia and renal abscess formation when compared to tlr4 wild-type mice with congenic bone marrow transplants. CONCLUSION: These data suggest that TLR4 is required on both intrinsic renal cells (e.g., tubular epithelial cells) and bone marrow-derived immune cells for the control of ascending uropathogenic E. coli infection by initiating chemokine-driven renal neutrophil recruitment.

Animals↗

PubMed1982

Symptomatic pyelonephritis in elderly men.

A prospective study was carried out of the clinical, laboratory, radiologic and therapeutic features of acute, symptomatic, bacterial pyelonephritis as experienced by 12 consecutive elderly, noncatheterized men who required hospitalization. In spite of the advanced ages of the men and the inordinate frequency of bacteremia and septic shock, no patient died. "Appropriate" antibiotic therapy, supportive treatment, and, as importantly, a lack of associated "imminently" or "ultimately" fatal illnesses contributed to the 100 per cent survival rate. Guidelines are provided for the diagnostic evaluation and antibiotic therapy of community-acquired pyelonephritis in elderly men.

Aged↗

PubMed1976

Sequential determination of C-reactive protein in acute childhood pyelonephritis.

Serum CRP levels ranging between 10 and 200 mug/ml were found in 19 patients with acute pyelonephritis. Treatment with antibacterial drugs, to which the bacteria were fully sensitive, resulted in a rapid decrease of the CRP values and very low or trace amounts were attained within a week. In contrast, cases ineffectively treated and/or reinfected showed increasing or slowly decreasing CRP levels. It is suggested that repeated CRP determinations can be used as a diagnostic tool for the rapid detection of cases of acute pyelonephritis in which treatment is ineffective.

Acute Disease↗

PubMed1993

Typical technetium dimercaptosuccinic acid distribution patterns in acute pyelonephritis.

Technetium dimercaptosuccinic acid renal scintiscans in 37 children with clinical diagnosis of acute pyelonephritis were reviewed. In 18 children, follow-up scintigraphy was obtained after an interval ranging from 5 to 8 months. Uptake abnormalities were found in 89% of the children (74% of the kidneys). We were able to identify four typical pathological uptake patterns: (i) pole defect(s), usually wedge shaped (60%); (ii) lateral wedge shaped defect (4%); (ii) scattered multiple defects (21%); and (iv) swollen kidney without areas of diminished uptake (15%). Remaining pathology at follow-up was found in 52% of the kidneys. Vesicoureteric reflux was present in 33% of the children with scintigraphic signs of pyelonephritis. Frequencies of parenchymal changes in the acute phase and at follow-up were not significantly correlated to the presence of reflux.

Acute Disease↗

PubMed1975

The occurrence of mycoplasmas in the urinary tract of patients with chronic pyelonephritis.

Two groups of patients, each consisting of 40, were investigated for the occurrence of mycoplasmas in the urethra, bladder and upper urinary tract. Mycoplasmas were isolated significantly more frequently from the bladder urine of patients with chronic pyelonephritis than from patients with non-infectious urinary tract diseases. Furthermore, mycoplasmas were isolated from the upper urinary tract of 5 patients with chronic pyelonephritis, while mycoplasmas could not be cultivated from the upper urinary tract of patients with non-infectious urinary tract diseases.

Adult↗

PubMed1975

Bacterial antigen and acid phosphatase in macrophages in experimental pyelonephritis.

Experimental retrograde E. coli pyelonephritis was produced in rats. The study covered the period from 6-24 hours up to 6 months. Macrophages in the renal tissue were studied using immunofluorescence staining for bacterial E. coli antigen and histochemical staining for aicd phosphatase. A comparison of sections stained according to the two methods showed that antigen-containing macrophages in nearly all cases yielded a positive reaction for acid phosphatase. On the other hand, in several kidneys acid phosphatase-positive macrophages occurred which in consecutive sections studied by immunofluorescence did not contain antigen. The possibility of using staining for acid phosphatase as a screening method for the detection of active, antigen-containing macrophages in human chronic pyelonephritis is discussed.

Acid Phosphatase↗

PubMed1978

Protection against experimental Proteus mirabilis pyelonephritis in rats and significance of immunity.

Intraperitoneal immunization with formalin-killed bacteria as well as previous hematogenous infection with Proteus O3H1 showed a protective effect against hematogenous pyelonephritis in rats when the homologous strain was used. Transfer of hyperimmune antisera protected against hematogenously induced infection. Neither intravesical or intraperitoneal immunization with formalin-killed bacteria nor transfer of urines containing antibodies of the IgG class protected against ascending pyelonephritis when the O3H1 strain was used. Data are presented indicating that a rise of pH might decrease the biological effect of antibodies, suggesting that Proteus urease activity is a virulence factor of importance in this context.

Animals↗

PubMed1980

Experimental acute pyelonephritis in grivet monkeys, provoked by Staphylococcus saprophyticus.

Urinary tract infection by Staphylococcus saprophyticus was provoked in two female grivet monkeys. A non-hemagglutinating strain of S. saprophyticus was injected into the renal pelvis of one of the animals (monkey I), while in the other (monkey II), a hemagglutinating strain of the same species was inoculated into the bladder by suprapubic puncture. In monkey I, massive hematuria and proteinuria were demonstrated during the post-inoculation (p.i.) week, after which the monkey was killed. In monkey II, which was killed after 2 weeks, hematuria and proteinuria were present during the first 5 p.i. days. In both monkeys, S. saprophyticus was isolated in numbers < 10(5) bacteria/ml bladder urine on each p.i. day. Autopsy of monkey I revealed acute pyelonephritis and inflammatory changes in the ureter on the same side on which S. saprophyticus had been inoculated. In monkey II, both kidneys were enlarged and there were signs of acute pyelonephritis. The histopathological examination revealed microabscesses, interstitial infiltration and numerous leukocytes in the tubules. Both the ureters of monkey II were congested and microscopically an acute inflammatory reaction was found. Inflammatory signs were also present in the bladder. Scanning electron microscopy revealed cocci adhering to the epithelial lining of the urinary tract.

Acute Disease↗

PubMed1994

[A case of bilateral emphysematous pyelonephritis associated with diabetes mellitus and liver cirrhosis].

A 32-year-old woman was hospitalized with the chief complaints of high fever and right flank pain. The patient had received treatment for diabetes mellitus and liver cirrhosis. The patient's laboratory data indicated pyuria, renal dysfunction and hyperglycemia. E. coli was detected in the blood, urine and pus. Plain abdominal X-ray revealed gas shadows at the right renal region. Abdominal CT scanning also showed gas shadows in the renal parenchyma of both sides. A diagnosis of bilateral emphysematous pyelonephritis was made. Chemotherapy and retroperitoneal drainage was performed. After therapy, the patient's laboratory data was improved and the abnormal gas shadows disappeared. We reviewed 77 cases of emphysematous pyelonephritis, including our case, from the Japanese literature.

Adult↗

PubMed1972

Effect of antibacterial therapy on renal lysozyme levels in rats developing bacterial pyelonephritis.

In animals developing unilateral Proteus mirabilis-induced pyelonephritis, the total soluble renal lysozyme (SRL) of both kidneys undergoes a biphasic elevation. The second phase of elevated SRL is associated with the onset of chronicity in the infected kidney. To discover whether effective antibacterial therapy altered the second elevation of SRL, levels of SRL were determined in rats developing unilateral chronic pyelonephritis with and without effective regimens of antibacterial agents. Therapeutic doses of ampicillin and nitrofurantoin caused elevations of SRL in both kidneys of infected animals, but these differences were not statistically significant (P > 0.05). Both agents produce elevations of SRL in uninfected animals which were significant (P < 0.05) when compared with normal animals. Kanamycin sulfate at a therapeutic dose induced great elevations of SRL in kidneys of both infected and uninfected animals. It is concluded that infection per se is not the cause of the elevated SRL.

Animals↗

PubMed1981

Intrarenal concentrations of ampicillin in acute pyelonephritis.

The intracortical, medullary, and papillary distribution of ampicillin was studied in normal and pyelonephritic rats. At 4 days after induction of pyelonephritis, the animals were given a single injection of 100 mg of ampicillin per kg or were treated for 1 week with two daily doses of 100 mg/kg. Major differences in the intrarenal distribution of ampicillin were noted between normal and pyelonephritic animals. At 2 hours after injection, the concentrations of ampicillin in all parts of the infected kidneys were significantly lower (P less than 0.05) than in normal kidneys. The area under the curve (micrograms.minute per milliliter) over a 4-h period after single injection was much lower in the medulla (6.3 +/- 0.9) and papilla (29.6 +/- 4.2) of infected kidneys than in the medulla (11.2 +/- 1.6) and papilla (44 +/- 10.1) of noninfected kidneys. Whereas the ratio of concentration in tissue to concentration in serum ranged to 11.1 in the papilla of normal animals, this ratio was reduced to 2.4 in the presence of pyelonephritis. The diminution of the concentration gradient was also striking in the urine, where there was a reduction of more than threefold in pyelonephritic animals. One week of therapy resulted in a noticeable reduction of the inflammatory process associated with a return to near-normal intrarenal distribution of ampicillin. In normal rats treated with multiple doses, there were decreases of the antibiotic concentrations in serum and kidneys and in the area under the curve for these tissues.

Acute Disease↗