Acute Focal Bacterial Nephritis and Renal Abscess Associated with Vesicoureteral Reflux

Sugao, Hideki; Takiuchi, Hidekazu; Sakurai, Tsutomu

doi:10.1159/000281349

“…Abscesses are generally diagnosed in otherwise healthy individuals, but some factors increase the risk. These risk factors include: urinary tract conditions (infection, anomalies such as reflux and obstruction, urinary tract stones, neurogenic bladder, polycystic disease, tumor, peritoneal dialysis), primary infection elsewhere with subsequent seeding (originating from skin, dental, cardiac, respiratory, genital, abdominal, gastrointestinal, intravascular catheter and intravenous drug abuse), surgery (of the urinary tract including transplantation, and abdominal), immunodeficiency states, trauma to the kidney and diabetes mellitus 26–28,30 , 33–42 …”

Section: Genito‐urinary Suppurative Infections: Perinephric and Renalmentioning

confidence: 99%

“…Their duration is generally 1–3 weeks before diagnosis. They are typically associated with fever (89%) and with unilateral pain in the flank or abdomen or tenderness in the costovertebral angle 25 , 27–29,33 , 35–39,42 . Pain can be also referred to other sites.…”

Section: Genito‐urinary Suppurative Infections: Perinephric and Renalmentioning

confidence: 99%

Urinary tract and genito‐urinary suppurative infections due to anaerobic bacteria

Brook

¹

2004

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Anaerobes have been involved in many different types of urinary tract infection. This review describes the microbiology, diagnosis and management of urinary tract and genito-urinary suppurative infections caused by anaerobic bacteria. The types of infections of the urinary tract in which anaerobes have been involved include para-or periurethral cellulitis or abscess, acute and chronic urethritis, cystitis, acute and chronic prostatitis, prostatic and scrotal abscesses, periprostatic phlegmon, ureteritis, periureteritis, pyelitis, pyelonephritis, renal abscess, scrotal gangrene, metastatic renal infection pyonephrosis, perinephric abscess, retroperitoneal abscess and other infections. The anaerobes recovered in these studies were Gram-negative bacilli (including Bacteroides fragilis and pigmented Prevotella and Porphyromonas sp.), Clostridium sp., anaerobic Gram-positive cocci and Actinomyces sp. In many cases, they were recovered mixed with coliforms or streptococci. The recovery of anaerobes requires the administration of antimicrobial therapy that is effective against these organisms. These antimicrobials include metronidazole, chloramphenicol, clindamycin, a carbapenem, cefoxitin and the combination of a penicillin and a beta-lactamase inhibitor. Percutaneous drainage, open surgical drainage or nephectomy might be indicated for abscesses.

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“…(1,12) The majority of case series reported to date focus on pediatric patients, demonstrating a strong association between ABN and vesicoureteral reflux in 40% of cases. (2,7,13) Acute inflammation, edema, and diffuse leukocyte infiltration are histopathologic findings in ABN, as well as in APN. (4,6,14,15) It is important to differentiate ABN from other infectious renal processes because a more aggressive and prolonged treatment is required and there is also a high risk of renal abscess progression.…”

Section: Introductionmentioning

confidence: 99%

Acute bacterial nephritis. A descriptive study of an underdiagnosed entity

Madero-Morales

¹

,

Pallares-Méndez

²

,

Romero-Mata

³

et al. 2020

rmu

0

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Background: Acute bacterial nephritis is an infectious process diagnosed through imaging studies. The clinical course of the disease has been shown to be more aggressive than acute pyelonephritis. It continues to be underdiagnosed, thus there are few studies on the entity in the literature. Objective: To describe the clinical characteristics and imaging features of acute bacterial nephritis, as well as its clinical course. Design: A descriptive, retrospective case series was conducted. Materials and methods: Thirty-two cases of acute bacterial nephritis in patients admitted to the hospital within the time frame of 2009 to 2016 were reviewed. The patients’ clinical characteristics upon admission were registered, as well as inpatient clinical progression, culture results, and antibiotic therapy response. The imaging studies were re-evaluated and the diagnostic consistency with either the focal or multifocal disease presentation was confirmed. Results: Cases predominated in women (n=29, 90.62%) and the most frequently associated comorbidities were diabetes (n=16, 50%) and obesity (n=9, 28.25%). The most important clinical findings upon admission were fever (n=15, 46.87%) and leukocytosis (n=27, 84.38%). Escherichia coli was the most commonly isolated bacterium (63.63%). Both acute focal bacterial nephritis and acute multifocal bacterial nephritis were observed in 46.87% (n=15) and 53.13% (n=17) of the patients, respectively. Imaging studies were required for all diagnoses. Conclusion: Fever and leukocytosis are the main findings in acute bacterial nephritis. Imaging studies are necessary for making the diagnosis, given that acute pyelonephritis and acute bacterial nephritis cannot be clinically differentiated.

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“…(1,12) The majority of case series reported to date focus on pediatric patients, demonstrating a strong association between ABN and vesicoureteral reflux in 40% of cases. (2,7,13) Acute inflammation, edema, and diffuse leukocyte infiltration are histopathologic findings in ABN, as well as in APN. (4,6,14,15) It is important to differentiate ABN from other infectious renal processes because a more aggressive and prolonged treatment is required and there is also a high risk of renal abscess progression.…”

Section: Introductionmentioning

confidence: 99%

Acute bacterial nephritis. A descriptive study of an underdiagnosed entity

Madero-Morales

¹

,

Pallares-Méndez

²

,

Romero-Mata

³

et al. 2020

Rev Mex Urol

0

View full text Add to dashboard Cite

Background: Acute bacterial nephritis is an infectious process diagnosed through imaging studies. The clinical course of the disease has been shown to be more aggressive than acute pyelonephritis. It continues to be underdiagnosed, thus there are few studies on the entity in the literature. Objective: To describe the clinical characteristics and imaging features of acute bacterial nephritis, as well as its clinical course. Design: A descriptive, retrospective case series was conducted. Materials and methods: Thirty-two cases of acute bacterial nephritis in patients admitted to the hospital within the time frame of 2009 to 2016 were reviewed. The patients’ clinical characteristics upon admission were registered, as well as inpatient clinical progression, culture results, and antibiotic therapy response. The imaging studies were re-evaluated and the diagnostic consistency with either the focal or multifocal disease presentation was confirmed. Results: Cases predominated in women (n=29, 90.62%) and the most frequently associated comorbidities were diabetes (n=16, 50%) and obesity (n=9, 28.25%). The most important clinical findings upon admission were fever (n=15, 46.87%) and leukocytosis (n=27, 84.38%). Escherichia coli was the most commonly isolated bacterium (63.63%). Both acute focal bacterial nephritis and acute multifocal bacterial nephritis were observed in 46.87% (n=15) and 53.13% (n=17) of the patients, respectively. Imaging studies were required for all diagnoses. Conclusion: Fever and leukocytosis are the main findings in acute bacterial nephritis. Imaging studies are necessary for making the diagnosis, given that acute pyelonephritis and acute bacterial nephritis cannot be clinically differentiated.

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Acute Focal Bacterial Nephritis and Renal Abscess Associated with Vesicoureteral Reflux

Cited by 8 publications

References 10 publications

Urinary tract and genito‐urinary suppurative infections due to anaerobic bacteria

Urinary tract and genito‐urinary suppurative infections due to anaerobic bacteria

Acute bacterial nephritis. A descriptive study of an underdiagnosed entity

Acute bacterial nephritis. A descriptive study of an underdiagnosed entity

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