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Acute pyelonephritis is an exudative purulent localized inflammation of the renal pelvis (collecting system) and kidney. The kidney parenchyma presents in the interstitium abscesses (suppurative necrosis ), consisting in purulent exudate (pus): neutrophils, fibrin, cell debris and central germ colonies (hematoxylinophils).
Urinary tract infection in pediatric patients is a significant clinical issue, affecting approximately 7% of fevered infants and children. [43] If left untreated, the infection can ascend from the bladder to the kidneys, resulting in acute pyelonephritis, which leads to hypertension, kidney scarring, and end-stage kidney disease. [44]
Fosfomycin can be used as an effective treatment for both UTIs and complicated UTIs including acute pyelonephritis. [87] The standard regimen for complicated UTIs is an oral 3g dose administered once every 48 or 72 hours for a total of 3 doses or a 6 grams every 8 hours for 7 days to 14 days when fosfomycin is given in IV form.
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It is generally not recommended to perform routine radiographic imaging on patients who have simple urinary tract infections. When patients do not improve quickly with appropriate antibiotics , however, appropriate radiographic studies help diagnose pyonephrosis, emphysematous pyelonephritis, and renal and/or perirenal abscesses.
Patients who have experienced an acute renal infarction usually report sudden onset flank pain, which is often accompanied by fever, nausea, and vomiting. [ 4 ] The primary causes of renal infarction are hypercoagulable conditions, renal artery damage (usually brought on by arterial dissection ), and cardioembolic illness.
CVA tenderness is often present in acute pyelonephritis. [ 5 ] [ 4 ] [ 6 ] [ 7 ] CVA tenderness may be present in patients who have a kidney stone , [ 8 ] [ 7 ] a stone in the ureter , [ 8 ] a ureteropelvic junction obstruction, [ 8 ] a kidney abscess , [ 8 ] a urinary tract infection , [ 9 ] and vesicoureteral reflux . [ 10 ]
Once the acute phase of the nephritic syndrome is controlled, it is crucial to determine the underlying pathology that caused the onset of the acute nephritic syndrome and to treat that condition. If the underlying cause is not determined and treated appropriately, it increases the risk of a recurrence of nephritic syndrome or chronic kidney ...