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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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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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Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
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The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
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The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
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The pathophysiology of pneumonia involves the following steps:
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Related Experiment Video

Updated: Dec 22, 2025

Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
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Emphysematous Pyelonephritis and Hiccups, a Case Report.

Muhanna Kazempour1, Mahbobeh Oroei, Minoosh Shabani

  • 1Department of Internal Medicine, Loghman- Hakim Hospital, Shahid Beheshti of Medical Science, Tehran, Iran. muhanna.kazempour@gmail.com.

Iranian Journal of Kidney Diseases
|May 4, 2020
PubMed
Summary

Persistent hiccups as the sole initial symptom of emphysematous pyelonephritis (EPN) are rare. This case report details a diabetic patient whose hiccups resolved with antimicrobial therapy and double J stenting, highlighting an unusual presentation of EPN.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the renal parenchyma.
  • EPN typically presents with flank pain, fever, and signs of sepsis.
  • Hiccups are an uncommon presenting symptom for renal infections.

Observation:

  • A 47-year-old male diabetic patient presented with persistent hiccups as the only initial symptom.
  • Contrast-enhanced abdominal multi-slice CT scan confirmed Class 3B EPN.
  • No neurological deficits, hiccup-inducing medications, or gastrointestinal dysfunction were identified.

Findings:

  • The patient received antimicrobial therapy and double J stenting for EPN.
  • Complete resolution of hiccups occurred within one week.
  • No recurrence of hiccups was observed during follow-up.

Implications:

  • This case underscores the importance of considering EPN in patients with unexplained persistent hiccups, especially those with diabetes.
  • Highlights an atypical presentation of a serious renal infection.
  • Suggests prompt management with antibiotics and urinary drainage can lead to favorable outcomes.