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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 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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Related Experiment Video

Updated: Oct 12, 2025

Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
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Mycobacterium abscessus Periprosthetic Hip Infection Complicated by Superimposed Polymicrobial Infection: A Case

Nicholas Genovese1, Thomas Auld1, Lisa L Dever2

  • 1Rutgers New Jersey Medical School, Department of Orthopaedic Surgery, Newark, New Jersey.

JBJS Case Connector
|November 19, 2021
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This case report details a rare Mycobacterium abscessus prosthetic joint infection (PJI) after hip surgery, complicated by other bacteria. Successful treatment involved surgery and long-term antibiotics, with no recurrence after two years.

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Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Microbiology

Background:

  • Prosthetic joint infections (PJI) pose significant challenges in orthopedic surgery.
  • Mycobacterium abscessus is an emerging pathogen known for its resistance to antibiotics.
  • Hip hemiarthroplasty is a common procedure for hip fractures and arthritis.

Observation:

  • A 79-year-old male patient developed a prosthetic joint infection following hip hemiarthroplasty.
  • The infection was caused by Mycobacterium abscessus and complicated by a polymicrobial infection.
  • The patient underwent resection arthroplasty and received chronic suppressive antibiotic therapy.

Findings:

  • This is the first reported case of Mycobacterium abscessus hip PJI with superimposed polymicrobial infection.
  • The case highlights the diagnostic and therapeutic difficulties associated with M. abscessus infections.
  • A multidisciplinary approach, including aggressive surgical intervention and prolonged combination antimicrobial therapy, was crucial for successful management.

Implications:

  • This case underscores the importance of considering atypical pathogens like M. abscessus in recalcitrant PJIs.
  • It emphasizes the need for specialized diagnostic workups and tailored treatment strategies for complex prosthetic joint infections.
  • The successful outcome suggests that aggressive surgical management combined with appropriate, prolonged antibiotic therapy can be effective in treating challenging M. abscessus PJIs.