keyword
https://read.qxmd.com/read/38535058/periportal-edema-as-an-extrarenal-manifestation-of-acute-pyelonephritis
#1
JOURNAL ARTICLE
Yu-Yun Chang, Kuei-Hong Kuo
Acute pyelonephritis is a common infection of the upper urinary tract that affects approximately 250,000 adults in the United States. Individuals with acute pyelonephritis require hospitalization and intravenous antimicrobial therapy. Diagnoses of acute pyelonephritis are made on the basis of clinical and laboratory findings. Individuals with complex or severe acute pyelonephritis undergo contrast-enhanced computed tomography (CT) for the diagnosis and assessment of perirenal abnormalities. However, extrarenal manifestations, such as periportal edema and gallbladder wall thickening, may complicate the diagnostic process...
March 18, 2024: Diagnostics
https://read.qxmd.com/read/38500931/type-b-aortic-dissection-masquerading-as-acute-pyelonephritis-think-beyond-measures
#2
Anas Ibraheem, Abdullah Abdullah, Kumari Priyam, Rebin Fakhruddin
Aortic dissection (AD) is a life-threatening medical emergency with a high mortality rate if misdiagnosed; therefore, an urgent and precise diagnosis is crucial for prompt treatment. This article presents a rare case report of AD with an atypical clinical presentation that led to delayed diagnosis and a complicated clinical course. Herein, we aim to contribute to the existing literature by providing insights into the varied presentations of AD and offering valuable lessons for clinicians faced with similar diagnostic scenarios...
February 2024: Curēus
https://read.qxmd.com/read/38442961/wunderlich-syndrome-in-a-patient-with-pyelonephritis
#3
JOURNAL ARTICLE
Joshua Chin Howe Chia, Chiara Jiamin Chong, Yan Rong Yong, Poh Yong Tan
An elderly female patient with left pyelonephritis developed worsening left flank pain, hypotension and a drop in haemoglobin (Hb) from 97 g/L to 67g/L on the third day of her admission. There was no recent trauma, history of coagulopathy or risk factors for renal malignancy or vascular disease.A contrasted CT scan of the kidneys revealed a 3.8 cm left renal subcapsular haematoma with no active contrast extravasation. Her atraumatic subcapsular haematoma fulfils two out of three clinical features of Lenk's triad (acute flank pain, hypovolaemic shock), suggestive of Wunderlich syndrome...
March 5, 2024: BMJ Case Reports
https://read.qxmd.com/read/38393801/acute-uncomplicated-utis-in-adults-rapid-evidence-review
#4
JOURNAL ARTICLE
Peter K Kurotschka, Ildikó Gágyor, Mark H Ebell
An acute uncomplicated urinary tract infection (UTI) is a bacterial infection of the lower urinary tract with no sign of systemic illness or pyelonephritis in a noncatheterized, nonpregnant adult with no urologic abnormalities or immunocompromise. In women, a self-diagnosis of a UTI with the presence of typical symptoms (e.g., frequency, urgency, dysuria/burning sensation, nocturia, suprapubic pain), without vaginal discharge, is accurate enough to diagnose an uncomplicated UTI without further testing. Urine culture and susceptibility testing should be reserved for women with recurrent infection, treatment failure, history of resistant isolates, or atypical presentation to make a definitive diagnosis and guide antibiotic selection...
February 2024: American Family Physician
https://read.qxmd.com/read/38385414/prevalence-and-predictive-factors-of-urinary-tract-infection-in-kidney-transplant-recipients-a-10-year-study
#5
JOURNAL ARTICLE
Sonia Dziri, Awatef Azzabi, Ghassen Tlili, Wissal Sahtout, Ben Njima Soumaya, Saidi Wafa, Raja Boukadida, Senda Mrabet, Yosra Guedri, Dorsaf Zellama
OBJECTIVES: Urinary tract infections are the main infectious complications among kidney transplant recipients and are considered as a potential risk factor for poor graft outcomes. However, the risk factors of urinary tract infections are controversial. The purpose of our study was to estimate the incidence and predisposing factors of urinary tract infections in patients undergoing kidney transplant in our teaching hospital of Sahloul, Tunisia. MATERIALS AND METHODS: We retrospectively analyzed the charts of 141 consecutive adult kidney transplants that were performed at the Department of Nephrology, University Hospital of Sahloul, Tunisia, between January 2007 and April 2016...
January 2024: Experimental and Clinical Transplantation
https://read.qxmd.com/read/38361835/risk-factors-and-fetomaternal-outcome-in-pregnancy-related-acute-kidney-injury
#6
JOURNAL ARTICLE
Shipra Sandilya, Kumari Usha Rani, Rajesh Kumar
INTRODUCTION: Pregnancy-related acute kidney injury (PRAKI) is acute kidney injury (AKI) occurring during pregnancy, labor, and postpartum period. AKI is defined as suddenly impaired kidney function with the retention of nitrogenous and other waste products. In high population country like India, not all deliveries are done tertiary care. Even not all are registered one if delivery is conducted at a hospital setup. The majority of patients are being managed by available obstetrician at local places...
December 2023: Journal of Family Medicine and Primary Care
https://read.qxmd.com/read/38354140/cefepime-taniborbactam-in-complicated-urinary-tract-infection
#7
RANDOMIZED CONTROLLED TRIAL
Florian M Wagenlehner, Leanne B Gasink, Paul C McGovern, Greg Moeck, Patrick McLeroth, MaryBeth Dorr, Aaron Dane, Tim Henkel
BACKGROUND: Carbapenem-resistant Enterobacterales species and multidrug-resistant Pseudomonas aeruginosa are global health threats. Cefepime-taniborbactam is an investigational β-lactam and β-lactamase inhibitor combination with activity against Enterobacterales species and P. aeruginosa expressing serine and metallo-β-lactamases. METHODS: In this phase 3, double-blind, randomized trial, we assigned hospitalized adults with complicated urinary tract infection (UTI), including acute pyelonephritis, in a 2:1 ratio to receive intravenous cefepime-taniborbactam (2...
February 15, 2024: New England Journal of Medicine
https://read.qxmd.com/read/38321745/-retrograde-ureteroscopic-lithotripsy-with-ureteral-access-sheath-via-cutaneous-ureterostomy-after-urinary-diversion-a-case-report
#8
JOURNAL ARTICLE
Tetsuo Fukuda, Ryo Kawahata, Hironao Tajirika, Tatsuro Ishikawa, Junichi Matsuzaki
A 65-year-old man presented with a history of rectal cancer 20 years prior that led to the development of a cutaneous ureterostomy and a colostomy. Subsequently, the patient was diagnosed with acute complicated pyelonephritis due to a right ureteral stone. After the placement of a single J ureteral stent in the right ureter for therapeutic management, the patient was referred to our institution for treatment of the right ureteral stone. An abdominal computed tomography (CT) revealed an 11×8 mm stone in the upper right ureter...
January 2024: Hinyokika Kiyo. Acta Urologica Japonica
https://read.qxmd.com/read/38234955/an-atypical-presentation-of-emphysematous-pyelonephritis-complicated-by-methicillin-resistant-staphylococcus-aureus-bacteremia
#9
Matthew Carvey, Matthew Roehrs
Emphysematous pyelonephritis is an acute necrotizing infection of the renal parenchyma, collecting system, and surrounding perinephric tissue, characterized by the presence of gas within these locations on imaging. It is associated with high mortality rates and is often found in diabetic patients. We present the case of a 60-year-old female, with a past history of Von Willebrand disease and hypertension, who presented to our emergency department complaining of acute-on-chronic right knee, left hip, and paraspinal lumbar back pain with an increased frequency of falling for approximately one week...
December 2023: Curēus
https://read.qxmd.com/read/38191188/acute-cystitis-in-men-a-nationwide-study-from-primary-care-antibiotic-prescriptions-risk-factors-and-complications
#10
JOURNAL ARTICLE
Håkon Sætre, Marius Skow, Ingvild Vik, Sigurd Høye, Louise Emilsson
BACKGROUND: Research on acute cystitis in men is scarce and treatment guidelines differs between countries. Improved antibiotic stewardship is needed. AIM: To analyze antibiotic prescriptions and outcomes of Norwegian men diagnosed with cystitis in primary care. DESIGN & SETTING: We identified all episodes of acute cystitis in men diagnosed in Norwegian primary care during 2012-2019. Choice of antibiotic (from the Norwegian Prescription Database), treatment failure, re-prescription and complications were stratified by age, calendar year and risk factors...
January 8, 2024: BJGP Open
https://read.qxmd.com/read/38161637/urinary-tract-infection-associated-with-bacteremia-caused-by-vancomycin-resistant-enterococcus-following-continent-urinary-diversion
#11
Kai Morishita, Soichiro Kashiwabara, Yuki Matsumoto, Atsuhiro Mizushima, Kaori Hara, Toshihiko Agatsuma, Yuji Mimura, Hideyoshi Matsumura, Hiroya Mizusawa
KEY CLINICAL MESSAGE: Even in a country where vancomycin-resistant enterococcus is rare, multidrug-resistant organism precautions are necessary when admitting patients with a history of medical exposure in other countries. On admission, screening is necessary and if infection is confirmed, a multidisciplinary approach involving different specialists is required. ABSTRACT: The patient was a 49-year-old Japanese female living in the United States. Total pelvic exenteration for cervical carcinoma, Miami pouch formation, and ileostomy had been performed in the United States...
January 2024: Clinical Case Reports
https://read.qxmd.com/read/38161550/exploring-suspected-diagnoses-in-elderly-patients-a-case-study-of-potential-necrotizing-otitis-externa
#12
Luís A Rocha, Tiago Costa, Luciana Silva, Rafaela Veríssimo
Necrotizing otitis externa (NOE) is a rare invasive infection affecting the EAC and the base of the skull. This condition is more prevalent in the elderly, diabetics, and immunocompromised individuals, often attributed to the bacterium Pseudomonas aeruginosa . In this case report, we present the clinical scenario of a 90-year-old woman with a history of diabetes and epilepsy. Initially admitted with acute pyelonephritis, fever, and prostration, she subsequently developed left facial paralysis during treatment...
December 2023: Curēus
https://read.qxmd.com/read/38146580/delayed-diagnosis-of-primary-hyperparathyroidism-a-case-report
#13
Mónica Maria Silva
Primary hyperparathyroidism (PHPT) is characterized by an elevation in serum calcium levels, sometimes leading to aggravated clinical conditions, namely nephrolithiasis, nephrocalcinosis, and/or fractures. A 55-year-old patient was admitted to the hospital with acute obstructive pyelonephritis in March 2021, having another episode one year later. Initial blood and urine analysis detected inflammatory markers, namely C-reactive protein, and the presence of leucocytes and blood in the urine. The renal computed tomography scan exhibited renal asymmetry, nephrocalcinosis, and multiple kidney stones...
November 2023: Curēus
https://read.qxmd.com/read/38142409/has-the-covid-19-pandemic-affected-ureteral-stone-management-in-pregnant-women-a-retrospective-single-center-study
#14
JOURNAL ARTICLE
Abdolreza Haghpanah, Hooman Kamran, Dariush Irani, Erfan Kohansal, Mahdi Rahmanian, Lorenzo Defidio, Anahita Dehghani, Zahra Jahanabadi, Mohammad Reza Askarpour
INTRODUCTION: This study aimed to evaluate the effect of coronavirus disease (COVID-19) on the patients' referral in the pregnant population and also investigate each treatment approach's advantages and disadvantages for acute renal colic in pregnancy. METHODS: In this retrospective study, we included all pregnant women with ureteral stones referred to a referral center between January 2019 and March 2021. RESULTS: Among 53 pregnant women, 18 (33...
December 24, 2023: Urologia
https://read.qxmd.com/read/38130580/neutrophil-to-lymphocyte-ratio-as-a-predictor-of-primary-vesicoureteral-reflux-evolution-in-children-with-associated-acute-pyelonephritis
#15
JOURNAL ARTICLE
Carlos Delgado-Miguel, María José Martínez-Urrutia, Laura Espinosa, Leopoldo Martínez, Laura García Espinosa, Roberto Lobato, Susana Rivas, Ricardo Díez, Pedro López-Pereira, Francisco Hernández Oliveros
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) has been recently postulated as an inflammatory biomarker for the diagnosis of vesicoureteral reflux (VUR). The aim of this study is to determine the role of NLR as a predictor of evolution of primary VUR in patients with associated acute pyelonephritis (APN). METHODS: A retrospective observational cohort study was performed in patients with APN episodes with associated primary VUR diagnosed between 2013-2020. Patients were divided into two groups according to VUR evolution after APN: group A [spontaneous resolution (SR)] and group B [VUR complications development (CD) during follow-up: new APN or renal function worsening]...
November 28, 2023: Translational Pediatrics
https://read.qxmd.com/read/38100932/case-report-on-bilateral-emphysematous-pyelonephritis-in-a-non-diabetic-male-a-complex-treatment-journey
#16
B Balagobi, S Gobishangar, K Heerthikan, K Priyatharsan, J Nalayini, A Jenil
INTRODUCTION: Emphysematous pyelonephritis is a severe kidney infection characterized by gas formation, predominantly affecting diabetic women. Symptoms include fever, pain, and nausea, requiring urgent and accurate management due to its potentially fatal nature. CASE PRESENTATION: This article reports a successful management of a case of bilateral emphysematous pyelonephritis complicated with perinephric, retroperitoneal collection and urosepsis. DISCUSSION: Emphysematous pyelonephritis (EPN) is a severe kidney infection characterized by acute necrotizing infection in the renal tissue and nearby structures...
December 7, 2023: International Journal of Surgery Case Reports
https://read.qxmd.com/read/38050281/renal-abscess-complicating-acute-pyelonephritis-in-children-two-cases-report-and-literature-review
#17
REVIEW
Zhuqin Zhan, Xiaoliang Lin, Guangbo Li, Jinhua Zeng, Dequan Su, Jianying Liao, Qian Shen
RATIONALE: To describe the diagnostic and treatment approaches of renal abscesses complicated with acute pyelonephritis in children. PATIENT CONCERNS: Two children presented with fever, vomiting, and abdominal pain with no typical manifestations, like frequent urination, urgency, dysuria, hematuria, foam urine, and lumbago. Renal abscess complicating acute pyelonephritis was diagnosed by B-ultrasound and computed tomography enhancement. Moreover, inflammatory markers were elevated significantly, but routine blood and urine cultures were repeatedly negative...
December 1, 2023: Medicine (Baltimore)
https://read.qxmd.com/read/38009295/early-versus-delayed-ureterolithotripsy-following-obstructive-acute-pyelonephritis-treatment
#18
JOURNAL ARTICLE
Huseyin Ozgur Kazan, Muhammet Cicek, Hulya Caskurlu, Ramazan Gokhan Atis, Asif Yildirim
BACKGROUND AND OBJECTIVES: There is no recommendation on the timing of ureterolithotripsy after the treatment of obstructive acute pyelonephritis (APN). The effect of early and delayed ureterolithotripsy on postoperative urinary tract infection (UTI) and other complications was investigated. METHODS: Patients who underwent ureterolithotripsy after obstructive APN treatment between February 2017 and August 2021 were divided into two groups, those operated during hospitalization and those operated within 3 months after discharge...
November 27, 2023: Urologia
https://read.qxmd.com/read/37987379/application-of-precision-medicine-concepts-in-ambulatory-antibiotic-management-of-acute-pyelonephritis
#19
REVIEW
Morgan Pizzuti, Yuwei Vivian Tsai, Hana R Winders, Paul Brandon Bookstaver, Majdi N Al-Hasan
Acute pyelonephritis (APN) is a relatively common community-acquired infection, particularly in women. The early appropriate antibiotic treatment of this potentially life-threatening infection is associated with improved outcomes. The international management guidelines for complicated urinary tract infections and APN recommend using oral antibiotics with <10% resistance among urinary pathogens. However, increasing antibiotic resistance rates among Escherichia coli and other Enterobacterales to fluoroquinolones, trimethoprim-sulfamethoxazole (TMP-SMX), and beta-lactams has left patients without reliable oral antibiotic treatment options for APN...
October 24, 2023: Pharmacy (Basel, Switzerland)
https://read.qxmd.com/read/37928706/severe-emphysematous-pyelonephritis-as-a-complication-of-klebsiella-pneumonia-and-uncontrolled-diabetes-mellitus
#20
Mihir Rao, Jina Pakpoor, Douglas Pendse, Conrad von Stempel
A female in her 40s, with poorly controlled Type I diabetes mellitus, was brought to our tertiary hospital by ambulance after being found drowsy. Six days prior, she had self-discharged from the Intensive Care Unit whilst being treated for a Klebsiella pneumonia. At re-admission, she had an acute kidney injury with abdominal pain and clinical features of sepsis. Her presentation was attributed to ongoing Klebsiella pneumoniae infection; however, a chest radiograph showed marked improvement of pulmonary consolidations and an unusual subdiaphragmatic gas pattern...
November 2023: BJR Case Reports
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