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Complicated Acute pyelonephritis

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
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
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
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
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
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...
May 16, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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
Weerawat Manosuthi, Surasak Wiboonchutikul
BACKGROUND: Data on the success rate of sitafloxacin treatment in acute complicated urinary tract infection and pyelonephritis are limited. OBJECTIVES: To determine the success rate of a new oral fluoroquinolone, sitafloxacin, in acute complicated urinary tract infection and pyelonephritis. METHODS: A prospective study of 30 patients who were diagnosed with acute complicated urinary tract infection and pyelonephritis was conducted. Oral sitafloxacin 50 mg twice a day was given for 7 days...
2016: SpringerPlus
Lars S Bjerregaard, Christoffer C Jorgensen, Henrik Kehlet
BACKGROUND: Overall medical complications have been reduced after fast-track total hip (THA) and knee arthroplasty (TKA), but data on specific renal and urological (RU) complications are limited. METHODS: To describe the incidence and consequences of serious RU complications resulting in length of stay > 4 days or 30-day readmissions after fast-track THA and TKA, we conducted a detailed observational study based upon prospectively collected pre-operative data and a complete 30-day follow-up on complications and re-admissions in a unselected cohort of 8,804 consecutive fast-track THAs and TKAs...
March 30, 2016: Minerva Anestesiologica
Michael Yu, Kathryn Robinson, Cary Siegel, Christine Menias
This article provides pictorial review of complicated upper and lower genitourinary infections and their mimics. Imaging features of upper urinary tract infections including uncomplicated acute pyelonephritis, xanthogranulomatous pyelonephritis (XGPN), emphysematous pyelonephritis, perirenal abscess, and pyonephrosis are first reviewed and then followed by pictorial review of their mimics including contrast-associated nephrotoxicity, renal infarcts, malakoplakia, renal cell cancer, leukemia or lymphoma and Castleman's disease...
February 11, 2016: Current Problems in Diagnostic Radiology
H J Heppner, F Yapan, A Wiedemann
Due to the demographic shift, increasing numbers of geriatric patients are admitted to acute care hospitals of all levels of care. This means that special challenges must be met in the medical care and management of these patients.Immunosenescence and multimorbidity make elderly patients vulnerable to infectious diseases. Urinary tract infections range from "simple" cystitis to pyelonephritis and urosepsis and, at 25%, are the second most common form of infection in geriatric patients. It is often difficult to make a diagnosis because typical symptoms do not always occur...
February 2016: Aktuelle Urologie
F Moustafa, G Nguyen, T Mathevon, O Baud, J Saint-Denis, N Dublanchet, B Pereira, C Shinjo, J P Romaszko, L Dopeux, F Dutheil, J Schmidt
OBJECTIVES: Urinary tract infections, among the leading causes of antibiotic prescriptions in adult women, are complicated by increasing antibiotic resistance. Current recommendations propose a 7 day treatment with fluoroquinolones or a 10-14 day course of third-generation cephalosporins (3GC). Our aim was to study the efficiency and tolerance of a short 7 day treatment with 3GC in uncomplicated acute pyelonephritis in women aged between 18 and 65 years. PATIENTS AND METHODS: This study was an open, prospective, non-comparative, monocentric pilot study with consecutive patients...
June 2016: Journal of Antimicrobial Chemotherapy
Jayoung Lee, Hee Chul Nam, Boo Gyoung Kim, Hyun Gyung Kim, Hee Chan Jung, Ji Hee Kim, Geun Seok Yang, Youn Jeong Park, Ka Young Kim, Yu-Seon Yun, Young Ok Kim, Jihan Yu
There are some reports of renal vein thrombosis associated with acute pyelonephritis, but a case of renal artery thrombosis in acute pyelonephritis has not been reported yet. Here we report a case of renal artery thrombosis which developed in a patient with acute pyelonephritis complicated with sepsis-induced disseminated intravascular coagulation (DIC). A 65-year-old woman with diabetes was diagnosed with acute pyelonephritis complicated with sepsis. Escherichia coli was isolated from both blood and urine cultures...
December 2012: Kidney Research and Clinical Practice
Ji Won Min, Soon Kyu Lee, Yu Mi Ko, Ki Wook Kwon, Jeong Uk Lim, Yeong Bok Lee, Hye Won Lee, Yoo Dong Won, Young Ok Kim
Emphysematous pyelonephritis (EPN) is a life-threatening infection characterized by the formation of gas. Complications of EPN include septic shock, acute renal failure, and disseminated intravascular coagulation. Spontaneous subcapsular hematoma (SCH) has also been reported as a rare complication of EPN, although there have been no reports to date of this occurring prior to the presentation of EPN. We report a case of EPN that initially presented as spontaneous SCH. The patient was admitted for left flank pain, and initial computed tomography revealed SCH without any air shadows...
September 2014: Kidney Research and Clinical Practice
Emmanuel Canet, Lara Zafrani, Élie Azoulay
Kidney transplantation is the most common solid organ transplantation performed worldwide. Up to 6% of kidney transplant recipients experience a life-threatening complication that requires ICU admission, chiefly in the late posttransplantation period (≥ 6 months). Acute respiratory failure and septic shock are the main reasons for ICU admission. Cardiac pulmonary edema, bacterial pneumonia, acute graft pyelonephritis, and bloodstream infections account for the vast majority of diagnoses in the ICU. Pneumocystis jirovecii pneumonia is the most common opportunistic infection, and one-half of the patients so infected require mechanical ventilation...
June 2016: Chest
Soichiro Shimura, Ken-ichi Tabata, Dai Koguchi, Noriyuki Amano, Morihiro Nishi, Tetsuo Fujita, Kazumasa Matsumoto, Takefumi Satoh, Masatsugu Iwamura
Emphysematous pyelonephritis (EPN) is an acute, severe necrotizing infection of the renal parenchyma and perirenal tissue. A 72-year-old female patient with uncontrolled diabetes mellitus was admitted to a hospital with loss of consciousness and, fever. Laboratory data suggested acute inflammation and hyperosmolar hyperglycemic syndrome. The left EPN was accurately diagnosed after abdominal computed tomographic (CT) scan revealed renal parenchymal gas and fluid within the subcutaneous tissue and mediastinum...
December 2015: Hinyokika Kiyo. Acta Urologica Japonica
Bradley Kushner, Paul D Allen, Benjamin T Crane
OBJECTIVE: To understand how aminoglycosides such as gentamicin are used in a tertiary care setting. To familiarize otologists with the demographics and risk factors associated with gentamicin use at major medical centers to allow the possibility of early intervention. STUDY DESIGN: Retrospective review of existing clinical data. SETTING: University of Rochester Medical Center (URMC), including all associated hospitals (Strong Memorial Hospital, Highland Hospital, etc...
February 2016: Otology & Neurotology
A-K Labi, A E Yawson, G Y Ganyaglo, M J Newman
INTRODUCTION: Asymptomatic bacteriuria, the presence of bacteria in urine without symptoms of acute urinary tract infection, predisposes pregnant women to the development of urinary tract infections and pyelonephritis, with an attendant pregnancy related complications. OBJECTIVE: To measure the prevalence of asymptomatic bacteriuria among ante-natal clients at the Korle-Bu Teaching Hospital in Ghana and its' associated risk factors. METHODS: A cross-sectional study involving 274 antenatal clients was conducted over a period of 4 weeks...
September 2015: Ghana Medical Journal
A R Hurtarte-Sandoval, M D Navarro-Cabello, M A Álvarez-Rivas, A I Robles-López, M D Salmerón-Rodríguez, M L Agüera-Morales, A Rodríguez-Benot, P Aljama-García
BACKGROUND: Passenger lymphocyte syndrome (PLS) is a disease in which the donor's lymphocytes produce antibodies to the red blood cell antigens of the recipient, causing alloimmune hemolysis. CASE REPORT: We report the case of a 39-year-old woman with stage V chronic kidney disease on hemodialysis secondary to poorly controlled diabetes mellitus type 1. She received a simultaneous pancreas-kidney transplant from a cadaver donor. The donor was A- and the recipient was A+ without initial complications with normal renal and pancreatic function, and her hemoglobin (Hb) level was 10...
November 2015: Transplantation Proceedings
O B Loran, I V Serjogin, A L Hachatrjan, R I Guspanov
147 patients who underwent urinary intestinal diversion from 2004 to 2014 were selected for the retrospective study. The authors carried out a comparative analysis of rates of complications that arise from the direct ureterointestinal anastomosis. The mean age of patients was 54.2 ± 3.0 (36-69) years. 60 (40.81%) patients of group 1 underwent Nesbit's direct ureterointestinal anastomosis, while in 87 (59.19%) patients of group 2 Wallace-1 and Wallace-2 anastomoses were performed. Average follow-up was 5.6 (2-10) years...
July 2015: Urologii︠a︡
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