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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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 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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Urine Studies II: Urine Culture and Sensitivity Test01:26

Urine Studies II: Urine Culture and Sensitivity Test

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A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
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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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Crystal Growth: Principles of Crystallization01:25

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Crystallization is a phase transformation process in which crystals are precipitated from a supersaturated solution or formed from other sources. During crystallization, atoms or molecules arrange themselves into a well-defined, rigid crystal lattice to minimize energy.
Initiating crystallization involves manipulating the concentration of the solute and the temperature of the solution. Since crystal growth occurs when the ratio of concentration and solubility of the solute in the solvent...
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Urine Studies I: Urinalysis01:29

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Urinalysis is a widely used diagnostic test that analyzes urine's physical, chemical, and microscopic characteristics. Healthcare providers use it to detect and monitor various health conditions, including renal disease, urinary tract infections (UTIs), diabetes, and metabolic or systemic disorders.Components of UrinalysisUrinalysis consists of three primary components: physical, chemical, and microscopic examination. Each provides unique insights into the urine sample and, by extension, the...
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Diagnostic Challenges with Acyclovir Crystalluria - A Case Study.

Alicia R Andrews1, Darryl Yu1,2, Andrew W Lyon1,2

  • 1Pathology & Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

EJIFCC
|June 19, 2020
PubMed
Summary
This summary is machine-generated.

Acyclovir (ACV) can cause kidney damage through crystalluria. Promptly reporting abundant crystals in urine, especially during ACV treatment, is crucial for preventing acute kidney injury.

Keywords:
acute kidney injuryacycloviradverse drug reactioncrystalluriacrystals

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Area of Science:

  • Nephrology
  • Clinical Pathology
  • Pharmacology

Background:

  • Marked to abundant crystalluria can lead to significant morbidity, primarily acute kidney injury.
  • Intravenous acyclovir (ACV) administration is a known risk factor for pathological crystalluria, particularly with elevated drug concentrations in the kidneys.

Observation:

  • A case of crystalluria was observed in a patient receiving empirical intravenous acyclovir for suspected viral meningitis.
  • Urine analysis revealed opaque, "milky" urine containing abundant, long, needle-shaped crystals with bright birefringence under polarized light microscopy.

Findings:

  • The crystalluria was diagnosed as acyclovir crystalluria.
  • The presence of pathological crystalluria necessitates prompt recognition and communication by clinical laboratory staff.

Implications:

  • Timely reporting of moderate to abundant crystalluria is essential for clinical staff to modify treatment and mitigate the risk of acute kidney injury.
  • Laboratory personnel must be vigilant in recognizing acyclovir as a potential cause of pathological crystalluria.