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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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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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Acute Pyelonephritis I: Introduction01:27

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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...
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In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
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AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
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Emphysematous pyelonephritis: Outcome with conservative management.

R A Bhat1, I Khan, I Khan

  • 1Department of Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.

Indian Journal of Nephrology
|December 17, 2013
PubMed
Summary

Emphysematous pyelonephritis, a severe kidney infection with gas formation, affects patients often with diabetes. Conservative management was successful in most cases, but some required surgery or had fatal outcomes.

Keywords:
Diabetes mellitusemphysematous pyelonephritisurinary tract infection

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Urology

Background:

  • Emphysematous pyelonephritis is a rare, necrotizing infection of the kidney parenchyma.
  • This condition is characterized by gas formation within the renal tissue, indicating a severe necrotizing process.

Purpose of the Study:

  • To describe the clinical characteristics and management outcomes of patients with emphysematous pyelonephritis.
  • To highlight the prevalence of diabetes mellitus in affected individuals.

Main Methods:

  • Retrospective case series.
  • Analysis of eight patients diagnosed with emphysematous pyelonephritis over a two-year period.
  • Review of patient demographics, comorbidities, management strategies, and outcomes.

Main Results:

  • Eight patients (62.5% male, 37.5% female) aged 21-65 years were identified.
  • Diabetes mellitus was present in approximately 75% of the patients.
  • Six patients were managed conservatively with successful outcomes.
  • One patient underwent nephrectomy with percutaneous drainage.
  • One patient died without surgical intervention.

Conclusions:

  • Emphysematous pyelonephritis is a serious condition, frequently associated with diabetes mellitus.
  • Conservative management can be effective for selected patients.
  • Aggressive intervention, including surgery, may be necessary in severe cases, and mortality remains a risk.