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Diagnostic investigation of pyelonephritis

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Abstract

Urinary tract infections are common, especially among women, and cause significant morbidity. While prognosis is probably more dependent on whether or not an episode of urinary tract infection is complicated (ie, associated with functional, metabolic, or anatomic abnormalities of the urinary tract) or uncomplicated, anatomic localization of infection has important implications for therapy. Pyelonephritis is difficult to diagnose with a high degree of accuracy based on clinical findings alone. Radiologic imaging plays an important role in the diagnosis and management of selected patients. Noninvasive and inexpensive methods to allow accurate localization of infection are needed.

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References and Recommended Reading

  1. Schappert SM: National Ambulatory Medical Care Survey: 1992 Summary. Advanced Data from Vital and Health Statistics. No. 253. Hyattsville, MD: National Center for Health Statistics; 1994:94.

    Google Scholar 

  2. Stamm WE, Hooton TM, Johnson JR, et al.: Urinary tract infections: from pathogenesis to treatment. J Infect Dis 1989, 159:400–406.

    PubMed  CAS  Google Scholar 

  3. Patton JP, Nash DB, Abrutyn E: Urinary tract infection: economic considerations. Med Clin North Am 1991, 75:495–513.

    PubMed  CAS  Google Scholar 

  4. Stamey TA, Goven DE, Palmer JM: The localization and treatment of urinary tract infections: the role of bactericidal urine levels as opposed to serum levels. Medicine 1965, 44:1–36.

    Article  PubMed  CAS  Google Scholar 

  5. Fairley KF, Bond AG, Brown RB, et al.: Simple test to determine the site of urinary-tract infection. Lancet 1967, 2:427–428.

    Article  PubMed  CAS  Google Scholar 

  6. Tolkoff-Rubin NE, Cotran RS, Rubin RH: Urinary tract infection, pyelonephritis, and reflux nephropathy. In The Kidney, edn 6. Edited by Brenner BM. Philadelphia: WB Saunders Company; 2000:1449–1508.

    Google Scholar 

  7. Sobel JD, Kaye D: Urinary tract infections. In Principles and Practice of Infectious Diseases, edn 5. Edited by Mandell GL, Bennett JE, Dolin RL. Philadelphia: Churchill Livingstone; 2000:773–805.

    Google Scholar 

  8. Ronald AR, Nicollé LE: Infections of the upper urinary tract. In Diseases of the Kidney, edn 6. Edited by Schrier RW, Gottschalk CW. Boston: Little Brown; 1997:913–945.

    Google Scholar 

  9. Fairley KF, Carson NE, Gutch RC, et al.: Site of infection in acute urinary tract infection in general practice. Lancet 1971, 2:615–618.

    PubMed  CAS  Google Scholar 

  10. Pinson AG, Philbrick JT, Lindbeck GH, et al.: Fever in the clinical diagnosis of acute pyelonephritis. Am J Emerg Med 1997, 15:148–151.

    Article  PubMed  CAS  Google Scholar 

  11. Baldassarre JS, Kaye D: Special problems of urinary tract infection in the elderly. Med Clin North Am 1991, 75:375–390.

    PubMed  CAS  Google Scholar 

  12. Gleckman R, Blagg N, Hilbert D, et al.: Acute pyelonephritis in the elderly. South Med J 1982, 75:551–554.

    PubMed  CAS  Google Scholar 

  13. Little PJ: A comparison of urinary white cell concentration with the white cell excretion rate. Br J Urol 1964, 36:360–363.

    PubMed  CAS  Google Scholar 

  14. Stamm WE: Measurement of pyuria and its relation to bacteriuria. Am J Med 1983, 75suppl:53–58.

    Article  PubMed  CAS  Google Scholar 

  15. Brumfitt W: Urinary cell counts and their value. J Clin Pathol 1965, 18:550–555.

    PubMed  CAS  Google Scholar 

  16. Pollock HM: Laboratory techniques for detection of urinary tract infection and assessment of value. Am J Med 1983, 79–84.

  17. Pappas PG: Laboratory in the diagnosis and management of urinary tract infections. Med Clin North Am 1991, 75:313–325.

    PubMed  CAS  Google Scholar 

  18. Jenkins RD, Fenn JP, Matsen JM: Review of urine microscopy for bacteriuria. JAMA 1986, 255:3397–3403.

    Article  PubMed  CAS  Google Scholar 

  19. Kass EH: Asymptomatic infectious of the urinary tract. Trans Assoc Am Phy 1956, 69:56–64.

    CAS  Google Scholar 

  20. Stamm WE, Counts GW, Running R, et al.: Diagnosis of coliform infection in acutely dysuric women. N Engl J Med 1982, 307:463–468.

    Article  PubMed  CAS  Google Scholar 

  21. Rubin RH, Shapiro ED, Andriole VT, et al.: Evaluation of new anti-infective drugs for the treatment of urinary tract infection. Clin Infect Dis 1992, 15:S216–227.

    PubMed  Google Scholar 

  22. Lipsky BA: Urinary tract infections in men. Ann Intern Med 1989, 110:138–150.

    PubMed  CAS  Google Scholar 

  23. Thanassi M: Utility of urine and blood cultures in pyelonephritis. Acad Emerg Med 1997, 4:797–800.

    Article  PubMed  CAS  Google Scholar 

  24. McMurray BR, Wrenn KD, Wright SW: Usefulness of blood cultures in pyelonephritis. Am J Emerg Med 1997, 15:137–140.

    Article  PubMed  CAS  Google Scholar 

  25. MacMillan MC, Grimes DA: The limited usefulness of urine and blood cultures in treating pyelonephritis in pregnancy. Obstet Gynecol 1991, 78:745–748.

    PubMed  CAS  Google Scholar 

  26. Grover SA, Komaroff AL, Weisberg M, et al.: The characteristics and hospital course of patients admitted for presumed acute pyelonephritis. J Gen Intern Med 1987, 2:5–10.

    Article  PubMed  CAS  Google Scholar 

  27. Everaert K, Oostra C, Delanghe J, et al.: Diagnosis and localization of a complicated urinary tract infection in neurogenic bladder disease by tubular proteinuria and serum prostate specific antigen. Spinal Cord 1998, 36:33–38.

    Article  PubMed  CAS  Google Scholar 

  28. Kawashima A, Sandler CM, Goldman SM: Current roles and controversies in the imaging evaluation of acute renal infection. World J Urol 1998, 16:9–17. A well-referenced overview regarding the role of diagnostic imaging in renal infection and the advantages and disadvantages of the currently available imaging modalities.

    Article  PubMed  CAS  Google Scholar 

  29. Talner LB, Davidson AJ, Lebowitz RL, et al.: Acute pyelonephritis: can we agree on terminology? Radiology 1994, 192:297–305.

    PubMed  CAS  Google Scholar 

  30. Kanel KT, Kroboth FJ, Schwentker FN, et al.: The intravenous pyelogram in acute pyelonephritis. Arch Intern Med 1988, 148:2144–2148.

    Article  PubMed  CAS  Google Scholar 

  31. Soulen MC, Fishman EK, Goldman SM, et al.: Bacterial renal infection: role of CT. Radiology 1989, 171:703–707.

    PubMed  CAS  Google Scholar 

  32. Behr MA, Drummond R, Libman MD, et al.: Fever duration in hospitalized acute pyelonephritis patients. Am J Med 1996, 101:277–280.

    Article  PubMed  CAS  Google Scholar 

  33. Sandler CM, Amis ES Jr., Bigongiari LR, et al.: Imaging in acute pyelonephritis. American college of radiology. ACR appropriateness criteria. Radiology 2000, 215Suppl:677–681. In this document, the American College of Radiology updates the appropriateness criteria for imaging in patients with pyelonephritis.

    PubMed  Google Scholar 

  34. Kim B, Lim HK, Choi MH, et al.: Detection of parenchymal abnormalities in acute pyelonephritis by pulse inversion harmonic imaging with or without microbubble ultrasonographic contrast agent. N J Ultrasound Med 2001, 20:5–14.

    CAS  Google Scholar 

  35. Kawashima A, Sandler CM, Goldman SM: Imaging in acute renal infection. Br J Urol Int 2000, 86(Suppl 1):70–79. A comprehensive overview of diagnostic imaging in pyelonephritis, written by the same authors as reference [28].

    Google Scholar 

  36. Gold RP, McClennan BL, Rottenberg RR: CT appearance of acute inflammatory disease of the renal interstitium. Am J Roentgenol 1983, 141:344–349.

    Google Scholar 

  37. Gold RP, McClennan BL, Kenney PJ, et al.: Acute infections of the renal parenchyma. In Clinical Urography. Edited by Pollack HM. Philadelphia: WB Saunders Co; 1990:799–821.

    Google Scholar 

  38. Hill GS: Renal infection. In Uropathology. Edited by Hill GS. New York: Churchill Livingstone; 1989.

    Google Scholar 

  39. Fabrizio MD, Chancellor MB, Rivas DA, et al.: The role of renal scintigraphy in the evaluation of spinal cord injury patients with presumed urosepsis. J Urol 1996, 156:1730–1734.

    Article  PubMed  CAS  Google Scholar 

  40. Kao CH, Hieh JF, Tsai SC, et al.: Using technetium-99m dimercaptosuccinic acid renal cortex scintigraphy to differentiate acute pyelonephritis from other causes of fever in patients with spinal cord injury. Urology 2000, 55:658–662.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Infectious Diseases, Department of Internal Medicine, Wayne State University School of Medicine, Harper Hospital, 4 Brush Center, 3990 John R, 48201, Detroit, MI, USA

    Kambiz Zandi-Nejad MD & Patricia D. Brown MD

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  1. Kambiz Zandi-Nejad MD
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  2. Patricia D. Brown MD
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Zandi-Nejad, K., Brown, P.D. Diagnostic investigation of pyelonephritis. Curr Infect Dis Rep 3, 529–533 (2001). https://doi.org/10.1007/s11908-001-0090-8

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  • DOI: https://doi.org/10.1007/s11908-001-0090-8

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