Complicated Acute pyelonephritis

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...

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...

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...

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]...

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...

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...

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...

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...

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...

INTRODUCTION: Ureteropelvic junction obstruction is often associated with renal calculus formation. However, there is no report of using robot-assisted laparoscopic pyeloplasty combined with percutaneous endoscopic surgery for ureteropelvic junction obstruction and renal calculi in a partial duplex system. CASE PRESENTATION: A 19-year-old female patient with lower moiety ureteropelvic junction obstruction and renal calculi in a partial duplex system was referred to our hospital because of left lumbar pain, left acute pyelonephritis, and an increase in left renal calculi during follow-up at the referral hospital...

Various infectious and inflammatory diseases affect the genitourinary system. This paper provides a review of multiple common and uncommon infectious and inflammatory conditions affecting the genitourinary system and some associated complications. These include acute infectious cystitis, emphysematous cystitis, acute pyelonephritis, emphysematous pyelonephritis, renal and perinephric abscesses, pyonephrosis, xanthogranulomatous pyelonephritis, epididymo-orchitis, vasitis, prostatitis, pelvic inflammatory disease, renal hydatid infection, renal tuberculosis, actinomycosis, Erdheim-Chester Disease, IgG4-Related Kidney Disease, urethritis and urethral strictures, ureteritis cystica, and genitourinary fistulas...

INTRODUCTION: Flexible ureterorenoscopy (fURS) has become one of the most frequent procedures in urology in recent years. The main problem on the way of the spread of flexible ureterorenoscopy in everyday urological practice all over the world is the fragility of endoscopes. MAIN AIM: To evaluate the potential use of reusable and single-use ureterorenoscopes for kidney stones. MATERIALS AND METHODS: The analysis included 30 patients who underwent of retrograde intrarenal surgery (RIRS) for kidney stones...

INTRODUCTION: Adolescent pregnancy is a physiological process, but it can evolve with premature delivery, severe obstetric or clinical pathologies, mortality, or sequelae for mother and child. We aim to report the progressive multiple organ dysfunction syndrome secondary to pyelonephritis and sepsis during prepartum, delivery, and puerperium of adolescent pregnancy and its sequelae. CASE REPORT: A 14-year-old adolescent with a pregnancy of 27 weeks of gestation controlled from 8 to 25 weeks...

BACKGROUND: Urinary tract infections (UTI) are the most common infectious complications after kidney transplantation (KTx) with highest incidence in the first three months of transplantation. UTI in transplant recipients increase morbidity and mortality, risk of graft failure and incidence of acute rejection episodes. According to published data, urinary tract infections significantly affect graft survival. The aim of our study was to identify possible risk factors for the development of UTI...

Fosfomycin, approved in the United States only for cystitis, is an attractive alternative for oral treatment of outpatient complicated urinary tract infections (cUTIs) as it has antimicrobial activity against most common uropathogens. The study was a multicenter, randomized, open-label pragmatic superiority clinical trial evaluating the efficacy of oral fosfomycin versus oral levofloxacin strategies in cUTIs (FOCUS study). The trial compared two strategies for initial or step-down oral therapy of cUTI without bacteremia after 0-48 hours of parenteral antibiotic therapy...

BACKGROUND: To avoid the overuse of antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), acting via cyclooxygenase (COX) inhibition, have been used to reduce pain and as an alternative treatment for uncomplicated urinary tract infections (UTIs). However, clinical studies evaluating NSAIDs versus antibiotics have reported an increased risk of acute pyelonephritis. Therefore, we hypothesized that COX inhibition could compromise the innate immune response and contribute to complications in patients with uncomplicated UTI...

INTRODUCTION: Endogenous Endophthalmitis is a rare ocular infection but with poor visual prognosis for most patients. Its most frequent etiology is Klebsiella spp., associated with hepatic abscesses and less frequently with perirenal abscesses. CASE PRESENTATION: We present a 61-year-old woman with a history of poorly controlled diabetes mellitus 2 that consulted several times for acute pyelonephritis with torpid evolution, associated with endogenous endophthalmitis in her right eye that required evisceration...

Xanthogranulomatous pyelonephritis (XGP) is an uncommon condition representing 1% of all renal infections. XGP due to complicated pyelonephritis associated with hepatic abscess is an extremely rare complication and has rarely been reported in the literature. We report a rare case of a 54-year-old female with a history of diabetes and recurrent urinary tract infections (UTI) who presented with acute right flank pain and fever which had been ongoing for four days. CT scan showed multiple bilateral obstructive nephrolithiasis associated with a liver abscess...

INTRODUCTION: This study compares the clinical and microbiological efficacy of ceftolozane/tazobactam (CTLZ/TAZ) and piperacillin/tazobactam (PIPC/TAZ) for treating complicated cystitis or acute pyelonephritis. METHODS: Patients who had been treated with empiric antibiotics, CTLZ/TAZ (52 cases) or PIPC/TAZ (47 cases), due to urinary tract infections (UTIs) were eligible for this study. Patients' demographic backgrounds, types of UTIs, and causative microorganisms isolated from urine or blood bacterial cultures were collected...

Post-splenectomy patients are at increased risk of infection. This complication is called overwhelming post-splenectomy infection (OPSI), which is uncommon but has high mortality. We describe a case of a man in his 80s who presented with septic shock with purpura fulminans caused by pyelonephritis. He had undergone a splenectomy in his 50s and had been taking prednisolone for the past six months for suspected immunoglobulin G4 (IgG4)-related disease. He was admitted to the intensive care unit but died the day after admission...