Severe renal sepsis in the very elderly

Milnes, J. P.; Swain, David G

doi:10.1136/pgmj.62.729.643

Postgraduate Medical Journal

1986

DOI: 10.1136/pgmj.62.729.643

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Severe renal sepsis in the very elderly

J. P. Milnes¹,

David G Swain²

Abstract: Summary:We describe three cases of severe renal sepsis in the very elderly and discuss the diagnostic pitfalls.

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1988

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Cited by 3 publications

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“…The symptoms and signs are often vague and misleading (1,5,8,9). Among 131 cases of pyonephrosis the most common clinical manifestations were fever (82%), loin pain (75%), palpable mass (70%); pyuria was registered in 70 per cent (2).…”

mentioning

confidence: 97%

Ultrasound in Renal Pyogenic Infection

Vehmas¹,

Pãivänsalo²,

Taavitsainen³

et al. 1988

Acta Radiol

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A series of 34 patients with renal or perirenal pyogenic infection (18 with pyonephrosis, 10 with renal abscess and 6 with perirenal abscess) is presented to evaluate diagnosis with ultrasound and treatment with percutaneous ultrasound guided aspiration/drainage. Specific findings, defined as sediment echoes or dispersed internal echoes in a hydronephrotic renal collecting system, were noted in 39 per cent of pyonephrosis cases. Abscesses were mainly round or oval hypoechoic lesions measuring from 2 to 15 em in diameter. Two abscesses were multilocular and one showed a septum. The appearance suggested tumor in 25 per cent. Because of this non-specificity of ultrasound we recommend diagnostic aspirations and further radiologic and other examinations in difficult cases. Four patients were treated by conservative means only, 13 with percutaneous aspiration or drainage, 9 with a combined drainage procedure and surgery, and 8 surgically. The length of the mean hospital stay was shortest in the group with the percutaneous drainage procedure (PDP) although the difference was not statistically significant. PDP was not effective in 12 per cent and surgery was used in these two cases to ensure cure. Complications occurred more often in the PDP group than in the surgery group but the most serious complication was a post-operative one. The different modes of treatment are discussed. The overall mortality was 5.9 per cent.

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mentioning

confidence: 97%

Ultrasound in Renal Pyogenic Infection

Vehmas¹,

Pãivänsalo²,

Taavitsainen³

et al. 1988

Acta Radiol

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Ultrasound in renal pyogenic infection

Vehmas¹,

Pãivänsalo²,

Taavitsainen³

et al. 1988

Acta Radiol

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Print) 1600-0455 (Online) Journal homepage: http://www.tandfonline.com/loi/iard20 Ultrasound in renal pyogenic infection T. Vehmas, M. Päivänsalo, M. Taavitsainen & I. Suramo To cite this article: T. Vehmas, M. Päivänsalo, M. Taavitsainen & I. Suramo (1988) Ultrasound in renal pyogenic infection, Acta Radiologica, 29:6, 675-678To link to this article: http://dx. AbstractA series of 34 patients with renal or perirenal pyogenic infection (18 with pyonephrosis, 10 with renal abscess and 6 with perirenal abscess) is presented to evaluate diagnosis with ultrasound and treatment with percutaneous ultrasound guided aspiratioddrainage. Specific findings, defined as sediment echoes or dispersed internal echoes in a hydronephrotic renal collecting system, were noted in 39 per cent of pyonephrosis cases. Abscesses were mainly round or oval hypoechoic lesions measuring from 2 to 15 cm in diameter. Two abscesses were multilocular and one showed a septum. The appearance suggested tumor in 25 per cent. Because of this non-specificity of ultrasound we recommend diagnostic aspirations and further radiologic and other examinations in difficult cases. Four patients were treated by conservative means only, 13 with percutaneous aspiration or drainage, 9 with a combined drainage procedure and surgery, and 8 surgically. The length of the mean hospital stay was shortest in the group with the percutaneous drainage procedure (PDP) although the difference was not statistically significant. PDP was not effective in 12 per cent and surgery was used in these two cases to ensure cure. Compiications occurred more often in the PDP group than in the surgery group but the most serious complication was a post-operative one. The different modes of treatment are discussed. The overall mortality was 5.9 per cent.

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Urinary Infection May Invalidate the Double-Sugar Test of Intestinal Permeability

Milnes

Walters

Andrews

et al. 1988

Scandinavian Journal of Gastroenterology

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To assess the effect of urinary infection on a typical double-sugar test of intestinal permeability, rhamnose and cellobiose were added to 12 infected urine samples to give sugar concentrations generally present in the 5-h urine samples of patients undergoing the test. Rhamnose concentration fell by approximately 20% in two of the specimens after incubation at 37 degrees C for 5 h. Eight of the 12 samples showed a fall in cellobiose concentration at 2.5 h, and 11 at 5 h. On five occasions more than 90% of the cellobiose was destroyed within 5 h. Yet only eight of these urine samples contained organisms that were able to metabolize cellobiose. This apparent anomaly may have resulted from bacteria surviving in spite of the thiomersal preservative, and then consuming the glucose to which the cellobiose was hydrolysed to enable calculation of cellobiose concentration. We conclude that bacteriuria may invalidate the result of the double-sugar test of intestinal function.

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Severe renal sepsis in the very elderly

Abstract: Summary:We describe three cases of severe renal sepsis in the very elderly and discuss the diagnostic pitfalls.

Cited by 3 publications

References 10 publications

Ultrasound in Renal Pyogenic Infection

Ultrasound in Renal Pyogenic Infection

Ultrasound in renal pyogenic infection

Urinary Infection May Invalidate the Double-Sugar Test of Intestinal Permeability

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