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PubMed1979

Efficacy of two trimethoprim-sulphonamide combinations in experimental pyelonephritis in the rat.

Co-trimazine, a new combination of trimethoprim and sulphadiazine intended for treatment of urinary tract infections, was tested and compared to co-trimoxazole in an experimental model of acute, obstructive pyelonephritis in the rat. The tests were carried out at four dose levels corresponding to the clinically recommended doses and to 1/4, 1/2, and 3/4 of the latter. The drugs were administered orally. Co-trimazine was found to have a greater antibacterial activity than co-trimoxazole and its use at a lower dosage than that of the latter appears warranted.

Animals↗
PubMed1983

Ceftazidime, ceftizoxime, cefotaxime and HR 221 in experimental chronic Escherichia coli pyelonephritis in rats.

The therapeutic efficacy and pharmacokinetics of the cephalosporins ceftazidime, ceftizoxime, cefotaxime and HR 221 were studied in animal experiments. The animal model used was experimental estrogen-induced or non-induced chronic Escherichia coli pyelonephritis in rats. The animals were treated with 5 mg cephalosporin/kg twice daily for one week. Each of the cephalosporins tested led to a significant decrease in renal bacterial counts, in spite of the low doses given. Ceftazidime was significantly more active than HR 221 in both experimental models, although the serum levels of HR 221 were higher and were maintained for a longer period of time than those of ceftazidime. Differences in pharmacokinetic properties (influenced by metabolic stability and protein binding) could be the reason for the differences in therapeutic activity, since the in vitro antimicrobial activity of each of the cephalosporins tested was very similar against the test strain.

Animals↗
PubMedDate not supplied

P-fimbriae studies on the diagnosis and prevention of acute pyelonephritis.

Theoretically there are several ways to prevent pyelonephritis and renal scarring caused by P-fimbriated Escherichia coli. Screening for individuals at risk, e.g. those carrying P-fimbriated pyelonephritogenic E. coli or those with high receptor density on their uroepithelial cells, could perhaps define a population where prophylaxis with a receptor analogue or vaccination with P-fimbriae may be relevant. Epidemiological measures in neonatal and maternity wards may prevent the nosocomial spread of virulent bacteria and reduce the number of colonized infants. However, no such methods have so far had any proven clinical relevance, and today, the important concern is still to try by conventional means--as we have always done--to get an early diagnosis and to treat the patient without delay.

Animals↗
PubMedDate not supplied

Pathogenesis of Escherichia coli cystitis and pyelonephritis: apparent lack of significance of bacterial motility and chemotaxis towards human urine.

All 45 microscopically motile urinary isolates tested here (37 Escherichia coli, two Enterobacter cloacae, two Citrobacter freundii, three Proteus mirabilis and one Proteus morganii) were strongly attracted to fresh human urine in a capillary chemotaxis assay. This observation suggested that urine taxis of gram-negative bacteria promotes their invasion of the human lower urinary tract and their ascension to the kidney(s). However, the incidence of motile isolates and their activity in urine taxis assays were similar for fecal E. coli isolates, for isolates from patients with recurrent cystitis and from patients with presumed pyelonephritis (E. coli blood isolates with concomitant E. coli bacteriuria). Thus, the present study of E. coli did not support the hypothesis that bacterial motility is a virulence factor in urinary tract infection.

Bacteriuria↗
PubMed1985

P-fimbriae studies on the diagnosis and prevention of acute pyelonephritis.

Theoretically there are several ways to prevent pyelonephritis and renal scarring caused by P-fimbriated Escherichia coli. Screening for individuals at risk, e.g. those carrying P-fimbriated pyelonephritogenic E. coli or those with high receptor density on their uroepithelial cells, could perhaps define a population where prophylaxis with a receptor analogue or vaccination with P-fimbriae may be relevant. Epidemiological measures in neonatal and maternity wards may prevent the nosocomial spread of virulent bacteria and reduce the number of colonized infants. However, no such methods have so far had any proven clinical relevance, and today, the important concern is still to try by conventional means-as we have always done-to get an early diagnosis and to treat the patient without delay.

Adult↗
PubMed1990

[Effectiveness and tolerance of cefixime in the treatment of acute pyelonephritis].

In a prospective, open clinical study, 50 urological patients with acute pyelonephritis were treated with the oral cephalosporin cefixime. The medication (2 x 200 mg/day) was given for seven to ten days. Clinical, bacteriological as well as hematological examinations were carried out prior to, during and immediately after therapy. A late check-up was performed five to nine days after the end of therapy. 46 of the 50 cases were evaluable for efficacy, and all 50 patients were included in safety evaluation. The most frequent pathogens isolated prior to therapy were Escherichia coli (34 times), Proteus mirabilis (six times), Klebsiella pneumoniae (twice) and coagulase-negative staphylococci (twice). Immediately after the end of therapy the pathogens were eradicated in 44 (97.5%) patients. At the late check-up the urine was sterile in 29 (63%) patients. A relapse was observed in 11 patients, a reinfection in four and the initially isolated pathogens had persisted in two. Immediately after the end of therapy 44 (95.7%) patients were clinically cured and two patients had improved. At the late check-up 41 patients were classified as clinically cured, three showed improvement, and two improvement with relapse. Adverse reactions (one case nausea and exanthem, and one case of meteorism) occurred in two patients. No changes in the blood counts or in the liver and kidney functions were observed. In the study described here cefixime proved to be an effective and well tolerated antibiotic for the treatment of upper urinary tract infections; it is of particular interest that 16 of the 50 patients presented with underlying disease favoring infection.

Acute Disease↗
PubMed1979

[Influence of cefaclor on experimental pyelonephritis (author's transl)].

A comparative study on the antibiotic activity of cefaclor and cephradine was performed in an infection and therapy model of acute pyelonephritis in the rat. Pathogens were Escherichia coli and Klebsiella pneumoniae. The antibiotics, which were administered orally, both had a pronounced effect in comparison to the untreated control group. Cefaclor was superior to cephradine in infections caused by K. pneumoniae.

Animals↗
PubMed1979

Efficacy of bacampicillin and ampicillin in experimental pyelonephritis in the rat.

Bacampicillin and ampicillin were tested and compared with each other in a model of acute, obstructive pyelonephritis in the rat. The compounds were administered orally at five dose levels ranging from 50 mg/kg to 150 mg/kg. Bacampicillin was found to have a greater therapeutic activity than ampicillin, particulary at the higher doses, indicating that its improved absorption properties make it a therapeutically more effective compound than ampicillin.

Ampicillin↗
PubMed1985

[Significance of kidney papillae in the pathogenesis of pyelonephritis and reflux nephropathy].

The role of the renal papillae in the pathogenesis of pyelonephritis and reflux nephropathy was studied by endoscopy and histology in adult autopsy kidneys. Compound papillae with a concave area cribrosa of the "reflux type" were found in greater frequency in adults than in children. Acute purulent inflammation in the renal parenchyma or coarse pyelonephritic scars were seen almost always overlying "refluxing" papillae or overlying papillae altered by papillary necrosis, obstructive atrophy and other changes of papillary shape. Intrapapillary tubular obstruction in early analgesic nephropathy, gout, myeloma and medullary cystic disease is an other factor favouring bacterial infection to occur. Without an underlying renal papillary damage renal injury attributable to urinary infection seems to be rare.

Adult↗
PubMed1990

Acute pyelonephritis due to a Kluyvera species in a child.

A Kluyvera sp. was recovered from the urine of a previously healthy 5-year-old child with clinical and laboratory evidence of acute pyelonephritis. This pathogen is usually a saprophyte and even when recovered in humans it is ordinarily considered an opportunistic pathogen. Only two other cases of Kluyvera infection have been described in immunocompetent individuals. The case presented further supports the finding that this bacterium can cause severe disease even in previously healthy, immunocompetent children.

Acute Disease↗
PubMed1994

Xanthogranulomatous pyelonephritis in childhood: ultrasound and CT diagnosis.

Four cases of diffuse xanthogranulomatous pyelonephritis (XPN) in young children are presented. In three patients the clinical picture was one of weight loss, anaemia and neutrophilia with a large renal mass. The fourth presented with haematuria. Ultrasound (US) and CT findings were almost identical in all four patients. US showed the affected kidney was massively enlarged but retained a reniform shape. Dilated fluid spaces containing calculi were present. CT confirmed the US findings and revealed peripheral enhancement without contrast excretion, with dilated calyceal spaces producing the "bear paw sign". Extrarenal extension into abdominal wall and psoas muscle is typical and was well demonstrated by CT. The affected kidneys were non-functioning and nephrectomy was required. Typical US and CT features allow a confident diagnosis of XPN and appropriate early treatment.

Child, Preschool↗
PubMed1994

Focal xanthogranulomatous pyelonephritis in a young child.

An 18-month-old female child presented with fever and an abdominal mass, which, after ultrasonography, computed tomography, and magnetic resonance imaging was considered to be an atypical cystic renal neoplasm. Nephrectomy was performed. Histopathological examination demonstrated the mass to be focal xanthogranulomatous pyelonephritis. This lesion should be considered in the differential diagnosis of renal neoplasms in childhood, particularly cystic Wilms' tumor or Wilms' tumor with significant intratumoral hemorrhage.

Diagnosis, Differential↗
PubMed1985

Observations on xanthogranulomatous pyelonephritis.

Four cases of xanthogranulomatous pyelonephritis, treated at the Department of Urology of the Military Medical Academy, are described. Focal lesions of the kidney were found in all of them. A precise pre- and intraoperative diagnosis is impossible or doubtful because the clinical symptoms and macroscopic appearance of the involved kidney suggest the presence of a tumour. Treatment consists mainly in nephrectomy.

Adult↗
PubMed1987

Serendipitous diagnosis of childhood xanthogranulomatous pyelonephritis in a child with osteomyelitis.

Xanthogranulomatous pyelonephritis (XGP), a rare chronic renal infection in children, usually presents as high fever, pyuria and an abdominal mass. This child with clinical and radiologic evidence of osteomyelitis was not suspected of renal disease until a non-functioning kidney was discovered during a bone scan. The pathologic proven diagnosis of XGP could have been made by correlative imaging using renal ultrasound, a renal scan and a gallium scan. Computed tomography and voiding cystourethrography provided additional information as to the nature and extent of the disease process.

Bone and Bones↗
PubMed1988

Potentials of ultrasonography for early diagnosis of primary chronic pyelonephritis.

Authors have studied retrospectively 44 patients with clinically proved primary chronic pyelonephritis with preserved renal function. The earliest sonographic changes consist of uneven renal outlines, PPI reduced below 1.5, irregular reduction of the renal parenchymal zone, slight increase in its echogenicity and disappearance of the image of the renal pyramids. These sonographic features can appear even when the renal concentration ability and isotope nephrogram with 131I-hippuran are not yet disturbed.

Adult↗
PubMed1998

Xanthogranulomatous pyelonephritis: report of four cases.

We report 4 patients with xanthogranulomatous pyelonephritis (diagnosed and treated between 1992 and 1996), aged 16 to 55 years (mean age 37 years). All had urolithiasis, pyonephrosis and nonfunctioning kidneys prior to surgical intervention, and underwent total nephrectomy. Clinical, laboratory and radiologic findings are discussed in the light of the cases reported in the literature.

Adolescent↗
PubMedDate not supplied

Emphysematous pyelonephritis and perinephric gas in a diabetic.

A case of emphysematous pyelonephritis with perinephric gas is presented. The patient was an elderly female diabetic and in addition had a subphrenic abscess as a complication of EPPG. Diabetes was not under control and E. coli was the sole pathogen. As the patient did not respond to conservative treatment, nephrectomy and drainage of subphrenic abscess were done and the patient improved rapidly.

Diabetic Nephropathies↗