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Calculous pyelonephritis.
S Koga1, Y Arakaki, M Matsuoka
1Department of Urology, Okinawa Chubu Hospital, Japan.
International Urology and Nephrology
|January 1, 1992
Summary
Calculous pyelonephritis with urinary obstruction is a severe condition, frequently causing positive urine cultures, bacteremia, and septic shock, often due to E. coli.
Area of Science:
- Nephrology
- Urology
- Infectious Diseases
Background:
- Calculous pyelonephritis, an infection of the kidney due to stones, presents a significant clinical challenge.
- Urinary tract obstruction by renal or ureteral calculi exacerbates kidney infections.
- High rates of positive cultures and bacteremia indicate the severity of this condition.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of patients with calculous pyelonephritis and urinary obstruction.
- To identify common causative organisms and the incidence of septic shock.
Main Methods:
- Retrospective analysis of 48 patients diagnosed with calculous pyelonephritis.
- Categorization of patients based on the location of calculi (renal vs. ureteral).
- Analysis of urine and blood cultures, and documentation of septic shock incidence.
Main Results:
- Urinary obstruction was attributed to renal calculi in 21 patients and ureteral calculi in 27.
- Positive urine cultures were observed in 87.5% of patients, with bacteremia in 70%.
- Escherichia coli, Proteus, and Klebsiella were the most frequent organisms; 20.8% experienced septic shock.
Conclusions:
- Calculous pyelonephritis, particularly when associated with urinary obstruction, is a critical condition with high rates of infection and systemic complications.
- Prompt recognition and management are crucial due to the risk of severe outcomes like septic shock.