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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...

Nephrons

Nephrons

The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma happens...

Urinary Tract Infection I: Introduction

Urinary Tract Infection I: Introduction

Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...

Kidney Transplant II: Surgical Procedure

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...

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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Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection

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Neonatal osteomyelitis and complex nephro-ureteral duplication.

Lisieux Eyer de Jesus¹, Alexandre Fernandes, Selma Maria Azevedo Sias

¹Departments of Surgery and Pediatrics, Disciplines of Pediatric Surgery, Pediatrics and Orthopedics, Antônio Pedro University Hospital, Federal Fluminense University, Rio de Janeiro, Brazil. lisieux@uol.com.br

Surgical Infections

|November 25, 2010

Summary

Urinary tract infections can cause femoral osteomyelitis in neonates with complex urinary malformations. Early diagnosis and treatment are crucial for favorable outcomes in these rare cases.

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Surgical Management of Meatal Stenosis with Meatoplasty

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Published on: November 30, 2010

Area of Science:

Pediatric Infectious Diseases
Neonatal Urology
Pediatric Orthopedics

Background:

Neonatal sepsis can lead to serious complications like osteomyelitis.
Urinary tract infections (UTIs) are a common cause of sepsis in neonates.
Complex congenital urinary anomalies increase the risk of UTIs.

Observation:

A female neonate presented with femoral osteomyelitis.
The neonate had a complex urinary malformation including bilateral renal duplication and a right ectopic ureterocele.
The osteomyelitis was secondary to a urinary tract infection.

Findings:

The patient received prolonged antibiotic therapy and underwent an upper pole nephrectomy.
Pathology confirmed chronic pyelonephritis and dysplasia in the resected kidney specimen.
After 1.5 years, the patient is asymptomatic with normal development, despite residual vesicoureteral reflux.

Implications:

This case highlights the importance of considering UTIs as the primary source of infection in neonates with sepsis and osteomyelitis.
It is the first reported instance of osteomyelitis complicating complex urinary duplication and UTI.
Prompt recognition and management of UTIs in neonates with congenital urinary anomalies are essential to prevent severe orthopedic sequelae.