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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).
For acute cystitis and pyelonephritis in pregnant women, empiric antibiotic treatment is often initiated. Commonly used antibiotics for uncomplicated cystitis include amoxicillin-clavulanate and fosfomycin, while parenteral beta-lactams are preferred for acute pyelonephritis. These options are chosen because they are considered safer in ...
Together with intravenous antibiotics, drainage [8] —either percutaneous or retrograde with a ureteral stent [9] —has become the cornerstone of treatment since the development of ultrasonography and computed tomography (CT) scanning. Drainage offers a great outcome with low rates of morbidity and mortality.
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. [87]
Antiglomerular basement membrane (anti-GBM) antibody - If positive, this is highly indicative of Goodpasture's syndrome and can be used to guide treatment. [9] Antineutrophil cytoplasmic antibody (ANCA) - If positive, this indicates that there is likely an underlying vasculitis that may be causing the acute nephritic syndrome. [36]
Acute kidney injury (AKI), previously called acute renal failure (ARF), [1] [2] is a sudden decrease in kidney function that develops within seven days, [3] as shown by an increase in serum creatinine or a decrease in urine output, or both. [4]
Pyelonephritis is a type of urinary tract infection that occurs when bacteria enters the body through the urinary tract. It causes an inflammation of the renal parenchyma, calyces, and pelvis. [12] There are three main classifications of pyelonephritis: acute, chronic and xanthogranulomatous.
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 ]