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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...

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...

Nursing Assessment of the Genitourinary System II: Inspection and Palpation

Nursing Assessment of the Genitourinary System II: Inspection and Palpation

The nursing assessment of the genitourinary (GU) system involves a systematic inspection and palpation to identify abnormalities in the kidneys, bladder, and surrounding structures.InspectionMouth: Inspect for signs of kidney dysfunction, such as stomatitis (inflammation of the mouth) and ammonia breath, which may occur in advanced kidney disease due to the buildup of urea, breaking down into ammonia.Skin: Check for pallor, which could indicate anemia caused by kidney disease. Look for...

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...

Nephrotic Syndrome III : Nursing Management

Nephrotic Syndrome III : Nursing Management

Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...

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Related Experiment Videos

Vulvar pyoderma gangrenosum with renal involvement.

Angelo V Marzano¹, Rim S Ishak, Riccardo Lazzari

¹Department of Anesthesia, Intensive Care and Dermatologic Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granada-Ospedale Maggiore Policlinico, Milan, Italy. angelovalerio.marzano@policlinico.mi.it

European Journal of Dermatology : EJD

|June 2, 2012

Summary

Pyoderma gangrenosum (PG) can affect the genital area and involve the kidneys. Early steroid treatment rapidly improved both skin lesions and renal function in a rare case.

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Area of Science:

Dermatology
Nephrology
Pathology

Background:

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis with unknown etiology, typically affecting the lower extremities.
Unusual presentations, including genital involvement and extracutaneous manifestations like sterile neutrophilic infiltrates, are infrequently reported.

Observation:

A case study of a 37-year-old female with pyoderma gangrenosum localized to the vulvar and perianal region.
Associated renal involvement included elevated serum creatinine, glomerular microhematuria, and proteinuria.

Findings:

The patient experienced a rapid and positive response of both mucocutaneous lesions and renal dysfunction following systemic steroid initiation.
Vascular involvement was noted, without overt vasculitis, suggesting potential histological hallmarks of genital PG.

Implications:

Highlights the necessity of evaluating all pyoderma gangrenosum patients for extracutaneous disease to prevent misdiagnosis and inappropriate treatments.
Emphasizes the importance of considering localized genital presentation and vascular changes in the diagnosis of pyoderma gangrenosum.