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Complicated Acute pyelonephritis

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https://www.readbyqxmd.com/read/28509126/gram-negative-sepsis-following-biopsy-of-a-transplant-recipient-with-asymptomatic-allograft-pyelonephritis
#1
Hassan Al-Khayyat, Nigel Toussaint, Steve Holt, Peter Hughes
Pyelonephritis post-renal transplantation is common and in up to 50% of cases can be asymptomatic. Transplant pyelonephritis shares a lot of histopathological features with acute cellular rejection. We present a case of asymptomatic acute graft pyelonephritis where a renal biopsy was complicated by sepsis, and discuss the difficulties in interpretation of renal histology in the setting of transplant pyelonephritis where rejection may also be a possibility, but differentiation is challenging.
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28435791/emphysematous-pyelonephritis-with-renal-artery-pseudoaneurysm
#2
Kevin Koo, Elias S Hyams
Emphysematous pyelonephritis is an acute infection of the renal parenchyma and perinephric tissues caused by gas-forming microorganisms, resulting in the radiographic presence of gas in the kidney, collecting system, and surrounding spaces. Here we present a case of severe emphysematous pyelonephritis in the setting of Klebsiella urosepsis. Surgical exploration of the flank revealed infectious disintegration of the renal parenchyma into a large phlegmon. The post-operative course was complicated by renal artery pseudoaneurysm and cutaneous fistualization of a perinephric fluid collection...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28430340/transurethral-contact-ureterolithotripsy-in-gas-%C3%B0-%C3%B0-2-medium
#3
Dmitry O Korolev, Peter V Glybochko, Leonid M Rapoport, Dmitry G Tsarichenko
BACKGROUND: Transurethral intracorporeal lithotripsy is the modality of choice for the endoscopic disintegration of large, long-standing, radiolucent or high-density stones. Despite several advantages and proven benefits of contact ureterolithotripsy/ureterolithoextraction (CULT), the application of irrigation carries significant risks of untoward perioperative events including retrograde stone migration and postoperative pyelonephritis. METHODS: We describe a new technique - endoscopic intracorporeal lithotripsy in the gas (СО2) medium...
April 14, 2017: Urologia
https://www.readbyqxmd.com/read/28394517/-technical-features-of-intestinal-ureteroplasty-art-6-simultaneous-ureteral-and-bladder-substitution
#4
B K Komyakov, A I Novikov, V A Ochelenko, B G Guliev, T Kh Al-Attar, M V Onoshko
AIM: To present the results and technical features of different methods of simultaneous ileal ureteral and bladder substitution. MATERIALS AND METHODS: From 2001 to 2016, 154 patients (mean age 52+/-9.2 years) underwent ileal and appendicular ureteroplasty. Of them, 70 (45.4%) were men and 84 (54.6%) women. Among them, 49 (31.8%) patients underwent ureteroplasty concurrently with orthotopic ileocystoplasty. The Studers ileal-ureter cystoplasty and Y-shaped bladder and ureteral reconstruction were performed in 38 (77...
April 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28338347/ceftazidime-avibactam-novel-antimicrobial-combination-for-the-treatment-of-complicated-urinary-tract-infections
#5
Jakhongir F Alidjanov, Moritz Fritzenwanker, Ivan Hoffman, Florian M Wagenlehner
Ceftazidime-avibactam is a combination of a third-generation cephalosporin and a novel non-beta-lactam beta-lactamase inhibitor. This combination was recently recommended for the treatment of complicated urinary tract infections, including acute pyelonephritis, in adults with limited or no alternative treatment options. The current review is aimed to determine activity, efficacy and safety of ceftazidime-avibactam in the treatment of patients with complicated urinary tract infections.
March 24, 2017: Future Microbiology
https://www.readbyqxmd.com/read/28248018/-diagnosis-and-treatment-of-cystitis-more-questions-than-answers
#6
E V Kulchavenya, S Yu Shevchenko, A G Cherednichenko
INTRODUCTION: Despite the prevalence of acute cystitis, there are still many unsolved problems of diagnosis and treatment of this disease. MATERIAL AND METHODS: To determine the nosological structure of dysuria, 126 female patients who sought medical attention for frequent painful urination were examined. To determine the incidence of outpatient visits to an urologist for patients with cystitis, medical records of 6753 patients of municipal outpatient clinic were analyzed...
November 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28247737/-experimental-modeling-of-acute-pyelonephritis
#7
M I Kogan, Y U L Naboka, I A Gudima, S K Bedjanyan
Acute pyelonephritis (AP) predominates among inflammatory infection kidney affections. In accordance to international classifications, AP is an upper urinary tract infection, subdivided into non-complicated (non-obstructive) and complicated (obstructive) forms. The clinical significance of AP presently is defined by the conditions frequent occurrence and its progression into chronic kidney disease. For a limited number of pathogens the involvement in AP is considered proven: representatives of the Enterobacteriaceae family (E...
August 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28247672/-a-giant-fecalith-complicated-by-acute-urinary-retention-hydronephrosis-and-acute-obstructive-pyelonephritis
#8
M I Davidov
The article reports a rare case of a 30-year-old man with Hirschsprung's disease, who developed a giant fecalith in the rectum and sigmoid (weight 3.5 kg, the largest diameter 20 cm). The fecalith impaired urine flow by compressing urinary tract, thereby causing acute urinary retention and right-sided hydronephrosis with acute obstructive pyelonephritis. Removing fecalith resulted in the patient recovery and normal functioning of genitourinary system.
April 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28193655/application-of-fluoroquinolone-resistance-score-in-management-of-complicated-urinary-tract-infections
#9
Ansal Shah, Julie Ann Justo, P Brandon Bookstaver, Joseph Kohn, Helmut Albrecht, Majdi N Al-Hasan
The fluoroquinolone resistance score (FQRS) predicts the probability of fluoroquinolone resistance with good discrimination. The score has been derived from patients with bloodstream infections caused by Gram-negative bacteria and is based on fluoroquinolone use within the past 6 months, among other clinical and health care exposure criteria. This study aims to examine the utility of the FQRS in patients with complicated urinary tract infections (cUTI) and determine whether extension of prior fluoroquinolone use to 12 months improves model discrimination...
May 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28108978/treatment-of-complicated-urinary-tract-infection-and-acute-pyelonephritis-by-short-course-intravenous-levofloxacin-750%C3%A2-mg-day-or-conventional-intravenous-oral-levofloxacin-500%C3%A2-mg-day-prospective-open-label-randomized-controlled-multicenter-non-inferiority
#10
Hong Ren, Xiao Li, Zhao-Hui Ni, Jian-Ying Niu, Bin Cao, Jie Xu, Hong Cheng, Xiao-Wen Tu, Ai-Min Ren, Ying Hu, Chang-Ying Xing, Ying-Hong Liu, Yan-Feng Li, Jun Cen, Rong Zhou, Xu-Dong Xu, Xiao-Hui Qiu, Nan Chen
OBJECTIVE: To compare the efficacy and safety of short-course intravenous levofloxacin (LVFX) 750 mg with a conventional intravenous/oral regimen of LVFX 500 mg in patients from China with complicated urinary tract infections (cUTIs) and acute pyelonephritis (APN). METHODS: This was a prospective, open-label, randomized, controlled, multicenter, non-inferiority clinical trial. Patients with cUTI and APN were randomly assigned to a short-course therapy group (intravenous LVFX at750 mg/day for 5 days) or a conventional therapy group (intravenous/oral regimen of LVFX at 500 mg/day for 7-14 days)...
March 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28043762/the-comeback-of-trimethoprim-in-france
#11
REVIEW
F Caron, V Wehrle, M Etienne
Already used in various countries, trimethoprim (TMP) was withdrawn from the French market in 1990, but should be soon available again. This article reviews the experience of TMP use around the world and its current use in Europe. Label use and guidelines only recommend the use of TMP for the treatment of urinary tract infections (UTI). Compared with co-trimoxazole (Co-T), a combination of TMP and sulfamethoxazole (SMX), TMP has (a) a similar resistance rate among Escherichia coli strains (estimated between 10 and 20% in uncomplicated cystitis), (b) a similar clinical efficacy for cystitis prevention and treatment, (c) a lower toxicity (as severe toxicity adverse effects of Co-T come from its sulfonamide component), (d) limited data for the treatment of pyelonephritis and male UTIs, and (e) an important impact on the microbiota...
December 30, 2016: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/27986362/acute-focal-bacterial-nephritis-in-a-cohort-of-hospitalized-adult-patients-with-acute-pyelonephritis-assessment-of-risk-factors-and-a-predictive-model
#12
Joaquin Campos-Franco, Cristina Macia, Emilio Huelga, Carla Diaz-Louzao, Francisco Gude, Rosario Alende, Arturo Gonzalez-Quintela
BACKGROUND: Acute focal bacterial nephritis (AFBN) is a complicated form of acute pyelonephritis (APN) characterized by single or multiple areas of localised infection in the kidney without liquefaction or abscess. Studies investigating AFBN in adults are scarce. AIM: The present study was aimed at evaluating the prevalence, associated factors, and presence of atypical clinical and radiological manifestations in adult AFBN patients. Also, we developed a clinical prediction model to evaluate the probability of AFBN in patients with APN...
April 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27939517/pyelonephritis-following-phenazopyridine-use
#13
Sean Patrick Nordt
We present a case of pyelonephritis following the extended andsolitary use of over-the-counter phenazopyridine in a forty-year-oldfemale. The patient initially had uncomplicated cystitis signs andsymptoms which partially resolved with phenazopyridine and therefore she continued use. She presented to the emergency department with systemicsigns and symptoms of acute pyelonephritis. As phenazopyridine is devoidof antibacterial properties this allowed the lower urinary tractinfection to progress to acute pyelonephritis requiring intravenousantibiotics...
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27688864/development-of-epidural-and-paraspinal-abscesses-after-insufficient-evaluation-and-treatment-of-acute-pyelonephritis-caused-by-staphylococcus-aureus
#14
Mi Jeoung Kim, Hyang Mo Koo, Woo Joo Lee, Jin Hwan Choi, Mi Nyong Choi, Sang Young Park, Woo Jung Kim, Seung Yeon Son
Diagnoses of pyelonephritis caused by Staphylococcus aureus should be accompanied by investigations of concomitant bladder obstruction and metastatic infections, especially to the spine or heart. Complicated pyelonephritis due to S. aureus requires more than 2 weeks of antibiotics, which is the typically recommended treatment duration for pyelonephritis. We describe a patient who was diagnosed with complicated epidural and paraspinal abscesses after insufficient evaluation and treatment of acute pyelonephritis due to S...
September 2016: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/27532362/fluoroquinolone-resistant-and-extended-spectrum-%C3%AE-lactamase-producing-escherichia-coli-infections-in-patients-with-pyelonephritis-united-states-1
#15
David A Talan, Sukhjit S Takhar, Anusha Krishnadasan, Fredrick M Abrahamian, William R Mower, Gregory J Moran
For 2013-2014, we prospectively identified US adults with flank pain, temperature >38.0°C, and a diagnosis of acute pyelonephritis, confirmed by culture. Cultures from 453 (86.9%) of 521 patients grew Escherichia coli. Among E. coli isolates from 272 patients with uncomplicated pyelonephritis and 181 with complicated pyelonephritis, prevalence of fluoroquinolone resistance across study sites was 6.3% (range by site 0.0%-23.1%) and 19.9% (0.0%-50.0%), respectively; prevalence of extended-spectrum β-lactamase (ESBL) production was 2...
September 2016: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/27414995/lumbar-facet-joint-septic-arthritis-presenting-atypically-as-acute-abdomen-a-case-report-and-review-of-the-literature
#16
Aysha Rajeev, Nameer Choudhry, Mazharuddin Shaikh, Mike Newby
INTRODUCTION: Septic arthritis of the lumbar facet joints is uncommon. The clinical presentation is unusual and patients usually presents with acute back pain or with signs and symptoms mimicking acute abdomen. PRESENTATION OF CASE: A 52year old man was admitted to the surgical ward with acute onset of abdominal pain and a provisional diagnosis of acute pyelonephritis. After the initial inconclusive investigations, magnetic resonance imaging was highly suggestive of lumbar facet joint septic arthritis...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27337839/-how-i-treat-a-renal-colic
#17
O Lavergne, Q Bonnet, A Thomas, D Waltregny
Renal colic (RC) represents nearly 2% of emergency department admissions. RC is defined by the occurrence of back pain which may radiate towards the abdomen and external genitals. In adults, the obstruction is caused by a urinary stone in 80% of cases. The 20 % of non-stone related RCs are due either to an intrinsic obstruction (pyeloureteral junction stenosis, ureteral tumor, ...) or an extrinsic compression (pelvic tumor, lymphadenopathy ...). In over 90% of cases, an RC does not require hospitalization and is treated with medication...
May 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/27313268/ceftazidime-avibactam-versus-doripenem-for-the-treatment-of-complicated-urinary-tract-infections-including-acute-pyelonephritis-recapture-a-phase-3-randomized-trial-program
#18
Florian M Wagenlehner, Jack D Sobel, Paul Newell, Jon Armstrong, Xiangning Huang, Gregory G Stone, Katrina Yates, Leanne B Gasink
BACKGROUND: The global emergence of carbapenem-resistant Enterobacteriaceae highlights the urgent need to reduce carbapenem dependence. The phase 3 RECAPTURE program compared the efficacy and safety of ceftazidime-avibactam and doripenem in patients with complicated urinary tract infection (cUTI), including acute pyelonephritis. METHODS: Hospitalized adults with suspected or microbiologically confirmed cUTI/acute pyelonephritis were randomized 1:1 to ceftazidime-avibactam 2000 mg/500 mg every 8 hours or doripenem 500 mg every 8 hours (doses adjusted for renal function), with possible oral antibiotic switch after ≥5 days (total treatment duration up to 10 days or 14 days for patients with bacteremia)...
September 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27198883/-renal-scarring-in-children-under-36-months-hospitalised-for-acute-pyelonephritis
#19
Begoña Rodríguez Azor, José Miguel Ramos Fernández, Sonia Sánchiz Cárdenas, Ana Cordón Martínez, Begoña Carazo Gallego, David Moreno-Pérez, Antonio Urda Cardona
INTRODUCTION: Acute pyelonephritis (APN) is one of the most common causes of serious bacterial infection in infants. Renal scarring is the most prevalent long-term complication. OBJECTIVES: To review the incidence of renal scarring within 6 months after an episode of APN in children under 36 months and its relationship with imaging studies, clinical settings, and bacteriology. METHOD: A retrospective study of previously healthy patients aged one to 36 months, admitted for a first episode of APN, with a minimum follow-up of 6 months...
February 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27197441/-acute-pyelonephritis-and-candidemia-due-to-candida-lusitaniae-a-case-report
#20
Motoyuki Tsuboi, Shunsuke Uno, Ryota Hase, Yudai Yano, Eiichiro Sando, Yoshihito Otsuka, Naoto Hosokawa
Although candiduria is becoming increasingly common among hospitalized patients, Candida lusitaniae is a rare pathogen that account for less than 1% of Candida species isolated from urine. Ascending pyelonephritis and candidemia due to Candida species are uncommon complications. We report herein on a case of acute pyelonephritis and candidemia due to C. lusitaniae. A 66-year-old man presented with a high fever during hospitalization at our hospital following septic shock due to ischial osteomyelitis treated with tazobactam/piperacillin for 29 days...
March 2016: Kansenshōgaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
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