Introduction: Pyonephrosis is a severe complication of pyelonephritis leading to rapid progression to sepsis and loss of renal function resulting in nephrectomy. Early identification of pyonephrosis based on clinical or radiological characteristics amongst pyelonephritis is paramount. This study aimed to determine the prevalence of pyonephrosis among patients with pyelonephritis admitted to the Department of Nephrology and Urology of a tertiary care centre.
Methods: This descriptive cross-sectional study was done in a tertiary care centre among patients with pyelonephritis from 1 July 2016 to 31 Jan 2021. Ethical approval was obtained from Institution Ethics Committee (Reference number: IEC/56/21). The available clinical, demographic and laboratory parameters were recorded from the hospital records in a predesigned proforma. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated.
Results: Among 550 pyelonephritis patients, the prevalence of pyonephrosis was 60 (10.9%) (8.3-13.5, 95% Confidence Interval). The mean age was 54.62±12.14 years, and 41 (68.33%) were males. The most common clinical symptom was flank pain with or without fever in 46 (76.66%) patients. Escherichia coli was the most common offending organism in 20 (33.33%). Ultrasonography showed classical echogenic debris with floaters and internal echoes in 44 (73.33%) patients. Double J stenting was successfully done in 44 (73.33%) patients. Percutaneous nephrostomy was done in the remaining 16 (26.66%) patients.
Conclusions: The prevalence of pyonephrosis in pyelonephritis is similar to previous studies done in similar settings.
Keywords: pyelonephritis; pyonephrosis; kidneys.
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http://dx.doi.org/10.31729/jnma.8015 | DOI Listing |
Urologia
January 2025
Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow, Lucknow, Uttar Pradesh, India.
Introduction: Pseudotumors are benign lesions which may mimic like a malignant tumor on conventional imaging. They are formed in kidneys which are scarred and deformed by chronic pyelonephritis, glomerulonephritis, trauma or infarction. There is a diagnostic dilemma in most of the cases as to differentiate RCC and pseudotumors.
View Article and Find Full Text PDFAntimicrob Steward Healthc Epidemiol
July 2024
Cardinal Health Innovative Delivery Solutions, Stafford, TX, USA.
Objective: The aim of this study was to determine if oral beta-lactam therapy is non-inferior to alternative therapy at discharge following inpatient treatment with an IV cephalosporin for acute pyelonephritis.
Design: Institutional Review Board (IRB)-approved, multicenter, retrospective, non-inferiority cohort (15% non-inferiority margin).
Setting: Six hospitals within two healthcare systems.
Radiol Bras
January 2025
Escola de Medicina - Universidade de Passo Fundo (UPF), Passo Fundo, RS, Brazil.
Objective: To identify and analyze the main findings on computed tomography (CT) scans ordered in the emergency department of a tertiary care hospital.
Materials And Methods: This was a cross-sectional observational study conducted through analysis of CT scans of the head, chest, and abdomen of all patients admitted to the emergency department of a tertiary care hospital over a period of four months.
Results: Among a sample of 331 patients, pathological radiological findings were observed in 59.
J Comp Eff Res
January 2025
Advanz Pharma, London, UK.
Compared with uncomplicated urinary tract infections (UTIs), complicated UTIs (cUTIs) including acute pyelonephritis (AP) present with significant morbidity, a higher risk of treatment failure and typically require longer courses of treatment, or alternative antibiotics. The emergence of drug-resistant organisms represents a considerable challenge in the treatment of patients with cUTIs/AP and has limited antibiotic options. Carbapenems are considered the current last line of therapy, however, carbapenem resistance represents a growing problem.
View Article and Find Full Text PDFRadiol Case Rep
March 2025
Emergency Radiology Department, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco.
Emphysematous pyelonephritis is a necrotizing infection of the renal parenchyma by gas-forming organisms, with a risk of the gas extending into peri-nephric or para-renal spaces and in advanced cases, the involvement may be extensive and bilateral. It is a common complication in patients with long-term diabetes, primarily caused by Gram-negative organisms or, in some cases, anaerobes. The diagnosis of emphysematous pyelonephritis is made by clinical features and confirmed by computed tomography.
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