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Acute pyelonephritis: analysis of 52 cases
Cristiana Rollino1, Roberto Boero, Michela Ferro
1Department of Nephrology and Dialysis, San Giovanni Bosco Hospital, Turin, Italy. nefro.gbosco@libero.it
Renal Failure
|October 17, 2002
Summary
Diagnosis of acute pyelonephritis (APN) can be made without positive urine cultures. Imaging like CT or MRI is crucial for detecting abscesses, which are common in APN patients.
Area of Science:
- Nephrology
- Radiology
- Infectious Diseases
Background:
- Acute pyelonephritis (APN) is common, but diagnosis and management remain challenging.
- Identifying risk factors for complications like abscesses and determining hospitalization criteria are key issues.
Purpose of the Study:
- To retrospectively analyze diagnostic approaches and outcomes in APN patients.
- To evaluate the utility of imaging in diagnosing APN and identifying complications.
- To assess the necessity of positive urine cultures for APN diagnosis.
Main Methods:
- Retrospective analysis of 52 APN patients with fever and loin pain.
- Review of diagnostic tests including urine and blood cultures, renal sonography, CT, and NMR.
- Comparison of clinical and laboratory findings between different patient groups.
Main Results:
- Positive urine cultures were found in only 22.9% of cases.
- CT scans identified abscesses in 28.5% of patients.
- No significant differences in clinical parameters were observed between patients with positive/negative CT or with/without abscesses.
- CT/NMR were more frequently used in Nephrology units.
Conclusions:
- Clinical and/or radiological findings are sufficient for APN diagnosis, even with negative urine cultures.
- Abscess formation is frequent and often not clinically apparent, necessitating systematic CT or NMR.
- Standardized diagnostic guidelines are needed due to variations in clinical management.