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Related Concept Videos

Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

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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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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 Kidney Injury IV: Diagnostic Studies and Prevention01:30

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Urinary Tract Infection II: Pathophysiology01:25

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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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Acute Kidney Injury II: Pathophysiology01:29

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Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
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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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Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
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Acute pyelonephritis in children.

William Morello1, Claudio La Scola1, Irene Alberici1

  • 1Nephrology and Dialysis Unit, Department of Pediatrics, Azienda Ospedaliero Universitaria Sant'Orsola-Malpighi, Via Massarenti 11, 40138, Bologna, Italy.

Pediatric Nephrology (Berlin, Germany)
|August 5, 2015
PubMed
Summary
This summary is machine-generated.

Acute pyelonephritis in children, often caused by E. coli, requires prompt diagnosis via urinalysis. Management balances effective treatment with minimizing antibiotic resistance and optimizing imaging strategies.

Keywords:
Acute pyelonephritisAntibiotic prophylaxisAntibiotic resistanceGuidelinesUrinary tract infectionsVesicoureteral reflux

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Area of Science:

  • Pediatric infectious diseases
  • Bacteriology
  • Urology

Background:

  • Acute pyelonephritis is a severe childhood bacterial illness, frequently caused by Escherichia coli.
  • Infants face risks of sepsis and meningitis; ambiguous symptoms and unreliable fever complicate early identification.
  • Increasing isolation of other bacterial species (Klebsiella, Enterococcus, Enterobacter, Proteus, Pseudomonas) is noted.

Purpose of the Study:

  • To review diagnostic and management strategies for acute pyelonephritis in children.
  • To discuss current approaches to antibiotic treatment, imaging, and prophylaxis.
  • To highlight areas needing further research for optimal long-term renal function preservation.

Main Methods:

  • Diagnosis relies on urinalysis, with dipstick tests for nitrites and leukocyte esterase as key indicators.
  • Urine culture via clean-voided methods is feasible even in young children.
  • Outpatient oral therapy is viable for well-appearing children.

Main Results:

  • New guidelines recommend less aggressive imaging post-infection, reducing radiation and costs.
  • Antibiotic prophylaxis efficacy for preventing recurrence is debated.
  • Antibiotic resistance is a concern, cautioning against widespread prophylactic use.

Conclusions:

  • Accurate diagnosis is crucial, with urinalysis and urine culture being vital.
  • Management strategies are evolving, emphasizing reduced imaging and cautious antibiotic use.
  • Further randomized controlled trials are needed to refine imaging protocols and medical interventions for preserving renal function.