Ultrasonography in the Differentiation of Complicated and Uncomplicated Acute Pyelonephritis

Neal, Durwood E.; Steele, Richard; Sloane, Bruce B.

doi:10.1016/s0272-6386(12)80063-1

Cited by 10 publications

(4 citation statements)

References 9 publications

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“…[14] Many studies have addressed the indication of radiological study in patients with acute pyelonephritis. [5] In our prospective study of patients with febrile UTI, 17 of 94 (18.1%) had major structural urologic abnormalities. [3] They suggested that a routine IVP is unnecessary in women with acute pyelonephritis and only those who fail to improve with appropriate treatment or with early recurrence (within 2 weeks of termination of treatment) require radiological evaluation.…”

Section: Discussionmentioning

confidence: 76%

“…Most studies suggest limiting radiological studies to patients exhibiting a slow response to appropriate antibiotic therapy [2,3] or those suspected to have complicated UTI. [5] We therefore conducted a prospective study to evaluate the prevalence of urinary tract abnormalities detected by ultrasonography in patients hospitalized for febrile UTI, and elucidate which clinical parameter may suggest the need for ultrasonography study. Ultrasonography can also be used for the separation of acute uncomplicated pyelonephritis from complicated pyelonephritis.…”

Section: Introductionmentioning

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: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

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

et al. 2003

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“…and Neal et al . were vague, describing a change in management as requiring an interventional procedure 18,19 . The definition of change in management was not explicitly stated by Wang et al 20 …”

Section: Resultsmentioning

confidence: 99%

“…17 procedure. 18,19 The definition of change in management was not explicitly stated by Wang et al 20 There was a large variation in abnormal US results associated with change in management. The highest reported rate of change in management was 59%, reported by Wang et al in a Taiwanese inpatient setting.…”

Section: Proportion With a Change In Managementmentioning

confidence: 99%

Ultrasound for acute pyelonephritis: a systematic review and meta‐analysis

Yu,

Sri‐Ganeshan,

Smit

et al. 2024

Internal Medicine Journal

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BackgroundThere is little consensus regarding the indications and utility of urinary tract imaging and type of imaging to perform in patients presenting with acute pyelonephritis (APN).AimsThe aims of this systematic review were to, among patients with APN, (i) identify the proportion of patients investigated with ultrasound (US), (ii) identify the proportion of abnormal US and (iii) identify the proportion of patients with a change in management resulting from abnormal US.MethodsA comprehensive search covered two electronic databases (Medline and EMBASE), with selection of studies performed independently by two investigators. Inclusion criteria were English language APN diagnosis and quantification of patients assessed with US or abnormal US results. Quality appraisal used the Newcastle–Ottawa instrument.ResultsThere were 35 studies included. The proportion of patients assessed with US was reported in 16 manuscripts and ranged from 20% to 94%, with significant heterogeneity and publication bias. The proportion of abnormal US was reported in 31 manuscripts and ranged from 7% to 79%. The proportion of abnormal US leading to change in management was reported in five studies and ranged from 7% to 59%. There was marked heterogeneity among studies included in all three subgroups.ConclusionsPatients with APN are commonly investigated with US, but only a small proportion have abnormalities and appear to be associated with changes in clinical management. The use of routine US for APN is therefore questioned. The identification of clinical variables for appropriate selection of patients to investigate with US requires further research.

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Toward Improved Empiric Management of Moderate to Severe Urinary Tract Infections

Leibovici

Greenshtain²,

Cohen³

et al. 1992

Arch Intern Med

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Ultrasonography in the Differentiation of Complicated and Uncomplicated Acute Pyelonephritis

Cited by 10 publications

References 9 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

Ultrasound for acute pyelonephritis: a systematic review and meta‐analysis

Toward Improved Empiric Management of Moderate to Severe Urinary Tract Infections

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