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Acute Pyelonephritis I: Introduction

Acute 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,...

Acute Pyelonephritis II: Diagnostic Studies and Management

Acute 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...

Acute Kidney Injury II: Pathophysiology

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...

Acute Kidney Injury I: Introduction

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...

Dialysis

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...

Urinary Tract Infection II: Pathophysiology

Urinary Tract Infection II: Pathophysiology

The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...

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Updated: Jul 3, 2026

Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis

Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis

Published on: July 18, 2017

Emphysematous pyelonephritis with acute renal failure.

Shiu-Dong Chung¹, Chun-Hou Liao, Hsu-Dong Sun

¹Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei, Taiwan. b3401095@mail2000.com.tw

|July 16, 2008

Summary

A 56-year-old woman with diabetes experienced abdominal fullness and vomiting, complicated by acute kidney injury and suspected emphysematous pyelonephritis. Prompt diagnosis and management are crucial for this severe diabetic complication.

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Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis

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Area of Science:

Nephrology
Endocrinology
Radiology

Background:

Obesity and poorly controlled diabetes mellitus are significant risk factors for various complications.
Acute kidney injury (AKI) in diabetic patients requires thorough investigation to identify underlying causes.

Observation:

A 56-year-old obese woman with hyperglycemia presented with abdominal fullness and vomiting.
Physical examination revealed no fever, flank pain, or dysuria.
Initial laboratory tests showed elevated blood urea nitrogen (74 mg/dL), creatinine (3.5 mg/dL), and white blood cell count (11.72 x 10(3)/mL).

Findings:

Severe hyperglycemia (826 mg/dL) and pyuria (WBC 30-50/HPF) were noted, with negative urine ketones.
Abdominal radiography identified right renal stones and localized air accumulation in the left upper abdomen.
The findings suggest a possible diagnosis of emphysematous pyelonephritis, a serious infection characterized by gas formation in the kidney.

Implications:

This case highlights the importance of considering rare but severe diabetic complications like emphysematous pyelonephritis in patients with uncontrolled diabetes and AKI.
Early recognition and aggressive management, including glycemic control and potentially surgical intervention, are critical for improving patient outcomes.
Further investigation with advanced imaging may be necessary to confirm the diagnosis and guide treatment.