Hemorrhagic focal bacterial nephritis: findings on gray-scale sonography and CT

Rigsby, C M; Rosenfield, Arthur T.; Glickman, Morton G.; Hodson, John

doi:10.2214/ajr.146.6.1173

Cited by 58 publications

(20 citation statements)

References 4 publications

(2 reference statements)

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“…The characteristic CT finding in these cases is a patchy area of delayed contrast enhance- Dec. 9 D ec.12 ment in the renal parenchyma [1,4,7], The pathophysio logical mechanism of the patchy enhancement has not been explained clearly, although this phenomenon has been considered to be compatible with renal vasoconstric tion. However, delayed patchy cortical excretion of con trast media by the kidney, which is not a phenomenon specific to EIARF, has been reported in hypovolemia [8], the recovery phase from rhabdomyolysis-related ARF [9], focal bacterial nephritis [10,11], and hemorrhage fever with renal syndrome [12], Furthermore, in our case the diminishment of blood flow and the increment of arterial resistance was observed in all four of the segmental arter ies examined by Doppler. Due to limited resolution, we cannot conclude that all of the intrarenal arteries were constricted.…”

Section: Case Reportsupporting

confidence: 46%

A Young Man with Acute Renal Failure and Severe Loin Pain

Izumi

Yokoyama²,

Yamauchi³

et al. 1997

Nephron

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The first case of exercise-induced acute renal failure (EIARF) is reported measuring the blood flow and arterial resistance in the kidney by pulsed Doppler ultrasound. A 20-year-old Japanese male suffered from severe loin pain and non-oliguric acute renal failure after strenuous exercise. Serum myoglobin and creatine phosphokinase were normal and urinary myoglobin was not detectable. The Doppler pattern in several segmental arteries showed a slow end-diastolic velocity (EV) and a high resistance index (RI), indicating increased renal vascular resistance, which suggested severe renal vasoconstriction. Three days later, the EV had apparently increased and the RI normalized in accordance with improvement of renal function. The ultrasound Doppler technique is useful for the detection of a decrease in arterial blood flow on real time and for the diagnosis of EIARF.

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Section: Case Reportsupporting

confidence: 46%

A Young Man with Acute Renal Failure and Severe Loin Pain

Izumi

Yokoyama²,

Yamauchi³

et al. 1997

Nephron

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“…The diffuse form of acute pyelonephritis may cause global enlargement, poor enhancement of renal parenchyma, absent excretion of contrast and streakiness of fat. Hemorrhagic bacterial nephritis which is relatively uncommon shows hyperattenuating areas representing parenchymal bleeding on non-contrast scan [5] . …”

Section: Acute Pyelonephritismentioning

confidence: 99%

Multimodality imaging of renal inflammatory lesions

Das

Ahmad

Sharma

et al. 2014

WJR

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Spectrum of acute renal infections includes acute pyelonephritis, renal and perirenal abscesses, pyonephrosis, emphysematous pyelonephritis and emphysematous cystitis. The chronic renal infections that we routinely encounter encompass chronic pyelonephritis, xanthogranulomatous pyelonephritis, and eosinophilic cystitis. Patients with diabetes, malignancy and leukaemia are frequently immunocompromised and more prone to fungal infections viz . angioinvasive aspergillus, candida and mucor. Tuberculosis and parasitic infestation of the kidney is common in tropical countries. Imaging is not routinely indicated in uncomplicated renal infections as clinical findings and laboratory data are generally sufficient for making a diagnosis. However, imaging plays a crucial role under specific situations like immunocompromised patients, treatment non-responders, equivocal clinical diagnosis, congenital anomaly evaluation, transplant imaging and for evaluating extent of disease. We aim to review in this article the varied imaging spectrum of renal inflammatory lesions. Multimodality imaging of renal inflammatory lesionsCore tip: Imaging in renal infections is challenging, given the relatively non-specific nature of findings in majority of the cases. A careful assessment of clinical situation in question is essential to accurately choose the imaging modality which would provide most information. In this review we discuss the appropriateness of specific imaging modalities, to allow the radiologist to choose the best modality for a given clinical situation. In addition, some entities such as acute pyelonephritis, Xanthogranulomatous pyelonephritis and emphysematous pyelonephritis have some specific imaging features. In this review we describe and illustrate such specific features, to facilitate their recognition when present.

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“…On ultrasonography, most APN appears normal; however, various findings can be revealed, such as single or multiple hyperechoic areas, kidney enlargement, pelvic wall thickening, hypoechoic areas, and perirenal fat involvement [3]. AFBN is characterized by renal masses without liquefaction on sonography or CT, and it can have either hyperechoic or hypoechoic echogenicity [1,[5][6][7][8]. Rathaus et al reported that 47 of 52 cases of AFBN showed a hyperechoic mass, whereas 5 cases showed hypoechoic [1].…”

Section: Discussionmentioning

confidence: 99%

“…That is, a hyperechoic lesion may indicate the incipient stage of AFBN and its echogenicity may change to hypoechoic with progression. Rigsby et al suggested that increased echogenicity reflects an acute hemorrhage resulting from the venous abnormalities and obstruction [2,8], which was evidenced by one of the histopathological findings of AFBN [2]. Although there are no reports on serial histopathological findings of AFBN, low echogenicity followed by high echogenicity may reflect liquefied lesions progressing to renal abscess.…”

Section: Discussionmentioning

confidence: 99%

Serial sonographic findings during progression from acute pyelonephritis to renal abscess: a rare case report

et al. 2016

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Renal abscess, accumulation of infective fluid in the kidney, is a rare pathology. Currently, no reports of the serial imaging changes of acute pyelonephritis (APN) progressing to renal abscess exist. We report clinical and serial sonographic findings of a patient with hyper-immunoglobulin E syndrome, a primary immunodeficiency, who developed APN that progressed to renal abscess. Renal ultrasonography revealed that echogenicity of infectious lesions dramatically changed from isoechoic to hyperechoic and to hypoechoic during progression. These findings are useful for differential diagnosis of APN, acute focal bacterial nephritis, and renal abscess.

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Hemorrhagic focal bacterial nephritis: findings on gray-scale sonography and CT

Abstract: Schoolof Medicine, 333 Cedar St., New Haven, CT 06510. Address reprint requests to C. M. Rigsby.

Cited by 58 publications

References 4 publications

A Young Man with Acute Renal Failure and Severe Loin Pain

A Young Man with Acute Renal Failure and Severe Loin Pain

Multimodality imaging of renal inflammatory lesions

Serial sonographic findings during progression from acute pyelonephritis to renal abscess: a rare case report

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