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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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...
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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,...
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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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Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
06:09

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Published on: July 18, 2017

Ischemic colitis secondary to xanthogranulomatous pyelonephritis.

Yu-Jang Su1, Yen-Chun Lai, Chin-Yao Chou

  • 1Department of Emergency Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan. yjsu@ms1.mmh.org.tw

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|October 11, 2008
PubMed
Summary

Xanthogranulomatous pyelonephritis (XGPN) is a rare infection complication presenting as a large abdominal mass. This case highlights XGPN causing ischemic colitis due to mass compression, a rarely seen complication.

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Area of Science:

  • Nephrology
  • Pathology
  • Gastroenterology

Background:

  • Xanthogranulomatous pyelonephritis (XGPN) is a rare, severe form of chronic obstructive pyelonephritis.
  • It is characterized by a suppurative granulomatous reaction to persistent bacterial infection, often associated with urinary tract obstruction.

Observation:

  • A 50-year-old woman presented with symptoms suggestive of XGPN, including an abdominal mass, pain, weight loss, anemia, and pyuria.
  • The patient developed ischemic colitis, a rare complication, due to compression of the transverse and descending colon by an exceptionally large XGPN mass.

Findings:

  • The case details an extensive Xanthogranulomatous pyelonephritis with an abdominal mass of unprecedented size.
  • The mass caused extrinsic compression leading to devascularization and ischemic colitis, a complication not typically associated with XGPN.

Implications:

  • This case underscores the potential for severe, unusual complications from Xanthogranulomatous pyelonephritis, including ischemic events.
  • It emphasizes the importance of considering XGPN in the differential diagnosis of abdominal masses and associated complications, guiding timely diagnosis and management.