Related Experiment Video
Updated: Jul 27, 2026
06:09
Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
Published on: July 18, 2017
[Septic shock due to pyonephrosis-calculosa: a case report].
A Takao1, Y Nakayama, T Ichikawa
1Department of Urology, Hiroshima City Hospital.
Summary
A severe kidney infection (pyonephrosis) with a stone caused septic shock in a 69-year-old woman. Prompt nephrectomy and intensive treatment successfully resolved her multiple organ failure and improved her condition.
Area of Science:
- Nephrology
- Critical Care Medicine
- Urology
Background:
- Septic shock is a life-threatening condition requiring prompt intervention.
- Pyonephrosis-calculosa, a severe kidney infection with stones, can lead to systemic complications.
- Multiple organ failure (MOF) presents a significant challenge in critical care.
Observation:
- A 69-year-old female presented with high-grade fever and clouded consciousness, indicative of severe illness.
- Clinical data revealed septic shock, disseminated intravascular coagulation (DIC), and MOF.
- Imaging showed left hydronephrosis, a peri-renal cystic mass, and a left ureteral stone.
Findings:
- The patient was diagnosed with septic shock secondary to pyonephrosis-calculosa and a peri-renal abscess.
- A left nephrectomy was performed, alongside endotoxin removal therapy and continuous hemodiafiltration (CHDF).
- Post-intervention, the patient's morbidities significantly improved, indicating treatment efficacy.
Implications:
- Nephrectomy combined with intensive medical management is a viable treatment for severe pyonephrosis-calculosa with abscess and MOF.
- Early diagnosis and aggressive intervention are crucial for managing complex urosepsis cases.
- Endotoxin removal and CHDF may play a supportive role in stabilizing patients with septic shock and MOF.
Related Concept Videos
01:27Acute Pyelonephritis I: Introduction
Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
01:28Urinary Tract Calculi I: Introduction
Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
01:28Urinary Tract Calculi V: Nursing Management
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
01:25Urinary Tract Calculi VI: Surgical Management
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...