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[Atypical forms of primary acute pyelonephritis]
1Service de néphrologie, hôpital Avicenne, Bobigny.
Abstract:
In acute "primary" pyelonephritis (APP), kidney infection occurs despite normal urinary tract morphology. Typical features of APP are spiking fever and chills, loin pain, pyuria, bacteriuria, isolation of uropathogenic strains of E. coli, and specific renal CT scan images. APP may be atypical when lacking pain, or fever, or when urine cultures are negative, or when urinary bacteria do not exhibit characters of uropathogenicity, or when CT scan examination is negative. Such atypical features entail loss of time in diagnosis, and thereby delayed treatment and increased risk of cortical scar formation. However, they are virtually never observed simultaneously in a given patient.
Insights
Acute primary pyelonephritis (APP) is a kidney infection with typical symptoms like fever and pain. Atypical presentations can delay diagnosis and treatment, increasing the risk of kidney scarring.
Area of Science:
- Nephrology
- Infectious Diseases
- Urology
Context:
- Acute primary pyelonephritis (APP) involves kidney infection without urinary tract abnormalities.
- Typical APP presents with fever, chills, loin pain, pyuria, bacteriuria, E. coli, and characteristic CT findings.
Purpose:
- To describe the typical and atypical presentations of acute primary pyelonephritis.
- To highlight the diagnostic challenges and potential consequences of atypical APP.
Summary:
- APP is characterized by fever, loin pain, and E. coli bacteriuria in patients with normal urinary tracts.
- Atypical APP may lack pain, fever, or exhibit negative urine cultures or CT scans.
- These atypical features can delay diagnosis and treatment, raising the risk of renal scarring.
Impact:
- Understanding atypical APP presentations is crucial for timely diagnosis and management.
- Early and accurate diagnosis of APP can prevent long-term kidney damage and complications.