Ultrasonography and Computed Tomography in Severe Urinary Tract Infection

June, Carl H.; Browning, Mark D.; Smith, L P; Wenzel, D; Pyatt, Robert S.; Checchio, Leonard M.; Amis, ES

doi:10.1016/s0022-5347(17)47485-4

Cited by 4 publications

(7 citation statements)

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“…June et al reported that 4 of 35 (11.4%) patients with febrile UTI had transient acute renal failure, which was unrelated to contrast administration, all of which had abnormal renal CT scans (10). In our study, transient reversible acute renal failure occurred in 3 of 94 (3.2%) patients.…”

Section: Discussionsupporting

confidence: 47%

“…Moreover, IVP couldn't clarify the space-occupying lesions nor diagnose renal abscesses. [10,11] However, like IVP, CT is also costly, and need contrast allergy and radiation exposure. [9] The disadvantage of ultrasonography is that it is unable to provide an image of the whole ureter, however it will show any secondary ureteropelvic dilatation if obstructive ureteric lesions are present.…”

Section: Discussionmentioning

confidence: 99%

“…[13] Newhouse et al also found significant abnormalities in 1.4% of 1000 women with recurrent UTI (a percentage that is not different from the general population). [10] In a retrospective analysis, Neal et al reported that 25 of 98 with acute pyelonephritis (26%) had major abnormal sonograms and that the only significant contributing factor for detecting a potentially serious complication (hydronephrosis or abscess) was the presence of diabetes mellitus. In a prospective study, Sandberg et al reported that 18 of 103 (17%) non-pregnant women with acute pyelonephritis had major structural urologic abnormalities detected by IVP.…”

Section: Discussionmentioning

confidence: 99%

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The Use of Ultrasonography in Evaluating Adults with Febrile Urinary Tract Infection

et al. 2003

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Use of Ultrasonography in Evaluating Adults with Febrile Urinary Tract Infection

et al. 2003

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“…In most cases, UTI can be diagnosed in adults from the clinical and laboratory ®ndings, and imaging is usually unnecessary. However, imaging is indicated when adult patients with UTI respond poorly to appropriate antibiotic therapy after 3 days [7,13,14,19]. In addition, when a de®nite diagnosis of acute renal infection is not established or when patients present with recurrent episodes of infection, renal imaging is indicated because there is more likelihood of stones, obstruction, abscess, or a congenital anomaly.…”

Section: Acute Pyelonephritis In the Adultmentioning

confidence: 99%

“…Therefore, the primary goal of renal imaging is to provide information about the nature and extent of the disease and to identify significant complications, e.g. gas‐forming infection, abscess and urinary obstruction [2,3,5–15].…”

Section: Introductionmentioning

confidence: 99%

Imaging in acute renal infection

Kawashima

Sandler

Goldman³

2000

BJU International

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Computed Tomography Imaging in Pyelonephritis and Its Complications

Belman¹,

Toka²,

Hedau³

2019

jemds

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BACKGROUND Acute pyelonephritis (APN) is a common disease which rarely evolves into abscesses. Urinary tract infections are the common urologic disease and the estimated annual incidence of pyelonephritis is 10.5 million to 25.9 million cases globally. In general, routine CT imaging is not required for diagnosis and treatment of uncomplicated cases in adult patients. It is of value in establishing the diagnosis in equivocal cases, in evaluating high-risk patients, and in determining the extent of disease and reveal complications such as abscess or obstruction. METHODSThis is a prospective study conducted over a period of 24 months from 2015 through 2017. We collected clinical, biochemical and radiological data of patients hospitalized with a diagnosis of APN. RESULTSWe identified the CT signs of acute pyelonephritis at different stages of the process. The typical CT-signs of AP were enlargement of the kidney with its thickened parenchyma and an impairment of corticomedullary differentiation. The highest incidence of acute pyelonephritis in our study was found in 41-50 years' age group accounting for 32% of cases and it was the least in the age group of 31-40 years constituting 0%. Out of total patients, 92% had unilateral pyelonephritis, while 8% had bilateral pyelonephritis, right kidney was involved in 48% of cases and left kidney was involved in 52% of cases. These finding correlated with previous studies wherein the left kidney involvement in pyelonephritis was marginally higher when compared to the right renal involvement. CONCLUSIONSCT is particularly useful for evaluating the complications of pyelonephritis such as abscesses and emphysematous pyelonephritis. It helps in defining the extent and severity of these complications. CT plays a critical role in the management of these complications, especially in critically ill patients and reducing the morbidity and mortality. Guided procedures are recommended for the drainage of collections or abscesses. KEY WORDSCT, Acute Pyelonephritis, Focal Nephritis, Renal Abscess, Urinary Tract Infection HOW TO CITE THIS ARTICLE: Belman M, Toka M, Hedau S. Computed tomography imaging in pyelonephritis and its complications. BACKGROUND Pyelonephritis is classically defined as an infection of the upper urinary tract involving the renal parenchyma and pelvis. It normally occurs as secondary to a bacterial infection in the lower urinary tract usually involving the bladder or urethra. This infection then ascends to involve the kidneys to cause acute pyelonephritis. (1) The natural flow of urine in the urinary tract is thought to prevent the build-up of pathogenic bacteria. Hence, any obstruction can cause stasis of urine and create conditions suitable for infection.

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Ultrasonography and Computed Tomography in Severe Urinary Tract Infection

Cited by 4 publications

References 0 publications

The Use of Ultrasonography in Evaluating Adults with Febrile Urinary Tract Infection

The Use of Ultrasonography in Evaluating Adults with Febrile Urinary Tract Infection

Imaging in acute renal infection

Computed Tomography Imaging in Pyelonephritis and Its Complications

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