Ultrasonography and Computed Tomography in Severe Urinary Tract Infection

June, Carl H.; Browning, Mark D.; Smith, Lauren; Wenzel, D; Pyatt, Robert S.; Checchio, Leonard M.; Amis, Edward S.

doi:10.1001/archinte.1985.00360050089016

Cited by 58 publications

(16 citation statements)

References 11 publications

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“…This is comparable to previous studies involving both men and women [15,18,[29][30][31][32]. However, we did not find an association between fever duration and elevated risk of underlying urinary tract abnormality [11,13,14,30].…”

Section: Discussionsupporting

confidence: 89%

Predicting the Need for Radiologic Imaging in Adults with Febrile Urinary Tract Infection

Nieuwkoop¹,

Hoppe²,

Bonten³

et al. 2010

CLIN INFECT DIS

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Section: Discussionsupporting

confidence: 89%

Predicting the Need for Radiologic Imaging in Adults with Febrile Urinary Tract Infection

Nieuwkoop¹,

Hoppe²,

Bonten³

et al. 2010

CLIN INFECT DIS

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“…Therefore, most patients with clinically suspected pyelonephritis have negative results from US. In one prospective study, US demonstrated abnormalities in only 24% of patients; other studies reported percentages as low as 20% (13,14). When positive findings of pyelonephritis are found at US, they can include congenital anomalies and a variety of changes in the renal parenchyma such as hydronephrosis, renal enlargement, loss of renal sinus fat due to edema, changes in echogenicity due to both edema (hypoechoic) or hemorrhage (hyperechoic) (Fig 3) (15), loss of corticomedullary differentiation, abscess formation, and areas of hypoperfusion (visible with power Doppler interrogation).…”

Section: Imaging Featuresmentioning

confidence: 92%

Pyelonephritis: Radiologic-Pathologic Review

Craig¹,

Wagner²,

Travis³

2008

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Urinary tract infections are the most common urologic disease in the United States and annually account for over 7 million office and 1 million emergency department visits. In adults, diagnosis of urinary tract infection is typically based on characteristic clinical features and abnormal laboratory values. Imaging is usually reserved for patients who do not respond to therapy and for those whose clinical presentation is either atypical or potentially life threatening. Urinary tract infection typically originates in the urinary bladder; when it migrates to the kidney or is seeded there hematogenously, a tubulointerstitial inflammatory reaction ensues, involving the renal pelvis and parenchyma. The condition is characterized as pyelonephritis. Complicated and uncomplicated pyelonephritis, xanthogranulomatous pyelonephritis, and tuberculosis are all urinary tract infections for which imaging evaluation adds diagnostic information important for patient care. Computed tomography (CT), when performed before, immediately after, and at delayed intervals from contrast material injection, is the preferred modality for evaluating acute bacterial pyelonephritis. CT is also preferred over conventional radiography and ultrasonography (US) for assessing emphysematous pyelonephritis. Xanthogranulomatous pyelonephritis is a chronic granulomatous process, induced by recurrent bacterial urinary tract infection. Although US is useful in the diagnosis of this condition, CT is the main imaging tool, as it provides highly specific findings and accurate assessment of the extrarenal extent of disease, which is essential for surgical planning. The increasing prevalence of tuberculosis and continued emergence of antibiotic-resistant strains have significance for genitourinary radiologists, as the urinary tract is the most common extrapulmonary site of tuberculosis. Familiarity with the renal manifestations of the disease--pelvoinfundibular strictures, papillary necrosis, cortical low-attenuation masses, scarring, and calcification--will help in the diagnosis, even in the absence of documented pulmonary disease.

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“…In confounding situations where significant clinical remissions are not seen following antibiotic therapy of 3 days, imaging is called for. 12,13 In the situation when a definite diagnosis of AP 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: Imaging Of Acute Pyelonephritis and Its Complications When Dmentioning

confidence: 99%

Acute Renal Infection in Adult, Part 1: An Overview of What the Radiologist Needs to Know

Hazarika

Venkataramanan

Das

et al. 2019

Journal of Gastrointestinal and Abdominal Radiology

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Acute renal infection or acute pyelonephritis (AP) denotes the process of inflammation of the renal parenchyma and its collecting system and the urothelium following infection. Uncomplicated AP commonly affects otherwise healthy, young women without structural or functional urinary tract abnormalities and without relevant comorbidities. More severe and complicated AP occurs in patients with a structurally or functionally abnormal genitourinary tract, or in persons with a predisposing medical condition like immune compromised state and diabetes. Complicated AP is characterized by a broader spectrum of clinical presentations, a wider variety of infecting organisms, and a greater risk of progression to a complication, such as intrarenal or perinephric abscess or emphysematous pyelonephritis and has the capacity to damage the organ and at times maybe life threatening. Role of imaging in renal infection is secondary, and in most situations, imaging is done to confirm the clinical diagnosis, map progression of disease in immune-compromised group of patients, or to evaluate for potential complications and therapeutic interventions. This article attempts to discuss the pathophysiology of AP from the standpoint of medical imaging and also brings out illustrative examples of various manifestations of AP and its complications. It provides imaging insight into various stages of inflammation, development of complication, and a roadmap for understanding AP through cross-sectional imaging.

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Ultrasonography and Computed Tomography in Severe Urinary Tract Infection

Cited by 58 publications

References 11 publications

Predicting the Need for Radiologic Imaging in Adults with Febrile Urinary Tract Infection

Predicting the Need for Radiologic Imaging in Adults with Febrile Urinary Tract Infection

Pyelonephritis: Radiologic-Pathologic Review

Acute Renal Infection in Adult, Part 1: An Overview of What the Radiologist Needs to Know

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