Acute focal bacterial nephritis in a cohort of hospitalized adult patients with acute pyelonephritis. Assessment of risk factors and a predictive model

Franco, J. Campos; Macía, Cristina; Huelga, Emilio; Díaz‐Louzao, Carla; Gudé, Francisco; Alende, Rosario; Gonzalez-Quintela, Arturo

doi:10.1016/j.ejim.2016.12.002

Cited by 14 publications

(26 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 The presence of perinephric fluid observed in our 2 patients is reported more frequently in cases of AFBN than APN. 10 In contrast to AFBN, renal abscesses have well defined margins and the content shows liquefaction, whereas tumors are more echogenic. 15,16 Power Doppler demonstrating hypovascularized zones can be useful in making the diagnosis (Figure 2B).…”

Section: Discussionmentioning

confidence: 98%

“…Acute focal bacterial nephritis was diagnosed in 57 cases (prevalence of 15.1%) based on the US findings of renal focal mass(es) of decreased, or less frequently increased, echogenicity and decreased vascularity on Doppler or when CECT revealed one or multiple wedge-shaped areas of decreased kidney density. 10…”

Section: Discussionmentioning

confidence: 99%

“…The role of oral contraceptive use as a risk factor is reported along with a 75% female predominance for AFBN. 5,10…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Acute Focal Bacterial Nephritis: Two Cases and Review of the Literature

Guella

Khan

Jarrah

2019

Can J Kidney Health Dis

View full text Add to dashboard Cite

Rationale:Acute focal bacterial nephritis (AFBN) has mainly been reported in pediatrics. It may be an underdiagnosed condition in adults because it resembles acute pyelonephritis (APN) in its clinical presentation.Presenting concerns of the patients:Two young women (25 and 27 years old, respectively) presented with complaints compatible with a diagnosis of APN. However in both, fever was of high grade, persistent for several days in spite of antibiotic administration, and there was demonstrated worsening of the inflammatory biomarkers. A contrast-enhanced computed tomography (CECT) led to the diagnosis in both cases.Diagnoses:Contrast-enhanced computed tomography reveals the most sensitive and specific images of AFBN. This includes wedge-shaped lesions with decreased enhancement, which may be focal or multifocal.Interventions (including prevention and lifestyle):Antibiotic therapy for at least 3 weeks.Outcomes:Resolution of AFBN was obtained after 3 weeks of antibiotics.Lessons learned:Our 2 cases illustrate the importance of CECT imaging to confirm the diagnosis of AFBN. Interstitial bacterial inflammation may have a worse prognosis if not diagnosed early and efficiently treated. Unlike APN, the management of AFBN requires at least 3 weeks of antibiotics to prevent the development of renal scarring and renal abscess.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Acute Focal Bacterial Nephritis: Two Cases and Review of the Literature

Guella

Khan

Jarrah

2019

Can J Kidney Health Dis

View full text Add to dashboard Cite

show abstract

“…The heterogeneously decreased enhancement in complicated ALN may represent more severe vascular and tubular dysfunction than in simple ALN. 7,15 Campos-Franco et al 16 , in a review of 377 hospitalized adult patients with acute pyelonephritis in all of whom imaging studies were performed(US or CT scan) found that the incidence of ALN was 15.1%. They reported that patients with ALN were younger (mean 44 years vs mean 55 years of age for ALN vs APN respectively) ,showed signs of more severe sepsis with lower systolic blood pressure and increased Intensive Care Unit admission rates, had more atypical symptoms (periumbilical pain, right or left quadrant pain, presence of Murphy's sign), had higher WBC and ESR values, higher incidence of Extended Spectrum Beta-lactamase producing bacteria , had more atypical radiologic findings (Pleural effusion, gall bladder thickening, presence of fluid around gall bladder, perirenal fluid and ascites), required longer hospital stay ,needed more days of therapy to become afebrile and overall longer duration of antibiotic therapy.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand diabetes or urinary manipulation was not more common in patients with ALN. 16 . Lobar nephronia may mimic tumor, abscess, or infection on ultrasonography.…”

Section: Discussionmentioning

confidence: 99%

Acute lobar nephronia: a condition more common in children, a road less travelled in the adults

Ruhela¹

2018

MOJCR

View full text Add to dashboard Cite

Acute lobar nephronia (ALN), also known as acute focal bacterial pyelonephritis, is a focal inflammation and bacterial infection of the kidneys without liquefaction or abscess formation. It is an interim between acute pyelonephritis and kidney abscess. ALN is a radiological diagnosis as clinical symptoms overlap with acute pyelonephritis (APN). ALN is more commonly reported in pediatric population and reports in adults are much more scarce likely due to under diagnosis. Imaging in adults is not routine for acute complicated UTI. ALN typically requires longer duration of antibiotics, and if suspected, clinicians should have a high degree of suspicion in order to obtain imaging studies for timely diagnosis, treatment and prevention of complications such as treatment failure or relapse. We present two cases of ALN in adults and a review of literature.

show abstract

Nothing Is Simple in Acute Pyelonephritis: A Pragmatic, Semantic Nephrologist’s View

Piccoli

Ragni

2017

Imaging and Intervention in Urinary Tract Infections and Urosepsis

View full text Add to dashboard Cite

Acute focal bacterial nephritis in a cohort of hospitalized adult patients with acute pyelonephritis. Assessment of risk factors and a predictive model

Cited by 14 publications

References 43 publications

Acute Focal Bacterial Nephritis: Two Cases and Review of the Literature

Acute Focal Bacterial Nephritis: Two Cases and Review of the Literature

Acute lobar nephronia: a condition more common in children, a road less travelled in the adults

Nothing Is Simple in Acute Pyelonephritis: A Pragmatic, Semantic Nephrologist’s View

Contact Info

Product

Resources

About