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Acute Pyelonephritis II: Diagnostic Studies and Management

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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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Endocarditis II: Clinical Features of Infective Endocarditis01:25

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Rheumatic Heart Disease I: Introduction01:23

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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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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Endocarditis I: Introduction01:25

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Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
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Related Experiment Video

Updated: Feb 26, 2026

Knee Arthrocentesis in Adults
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Septic arthritis associated with systemic sepsis.

Sung-Weon Jung1, Dong-Hee Kim2, Sung-Jin Shin2

  • 1Department of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 50, Hapsung 2-Dong, Changwon-si, Gyeongsangnam-do, Korea. can1204@hanmail.net.

International Orthopaedics
|July 19, 2017
PubMed
Summary

Concurrent systemic sepsis in septic arthritis patients is linked to longer symptom duration, higher inflammatory markers, and comorbidities. This combination predicts poorer outcomes, including infection recurrence and disease progression.

Keywords:
OsteoarthritisRecurrenceSepsisSeptic arthritis

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Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Septic arthritis, an infection of the joint, can lead to severe outcomes.
  • Concurrent systemic sepsis is a known complication, but its predictors and impact on outcomes require further investigation.

Purpose of the Study:

  • To identify factors associated with concurrent systemic sepsis in patients with septic arthritis.
  • To determine if concurrent systemic sepsis predicts poor outcomes in septic arthritis.

Main Methods:

  • A retrospective review of 137 adult patients with acute septic arthritis who underwent surgical debridement.
  • Patients were categorized into two groups: septic arthritis alone and septic arthritis with concurrent systemic sepsis.
  • Comparison of patient characteristics, laboratory findings, synovial fluid analysis, and surgical outcomes between the groups.

Main Results:

  • 29.9% of patients presented with concurrent systemic sepsis.
  • Factors significantly associated with systemic sepsis included longer prodromal symptom duration, higher serum neutrophil percentage, elevated C-reactive protein, higher Charlson comorbidity index, positive synovial fluid cultures, and methicillin-sensitive Staphylococcus aureus (MSSA) isolates.
  • Systemic sepsis was associated with increased rates of repeated debridement, infection recurrence, and arthritis progression.

Conclusions:

  • Concurrent systemic sepsis in septic arthritis is associated with specific clinical and laboratory factors.
  • The presence of systemic sepsis significantly correlates with adverse outcomes, including higher rates of infection recurrence and joint damage progression.