Pyelonephritis classification: Difference between revisions
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Created page with "__NOTOC__ {{Pyelonephritis}} {{CMG}} ==Overview== ==Classification== There are four different types of pyelonephritis: * '''Acute Pyelonephritis''' :*Acute pyelonephritis..." |
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* '''Acute Pyelonephritis''' | * '''Acute Pyelonephritis''' | ||
:*Acute pyelonephritis is a common clinical diagnosis in patients who present with fever, chills, and flank tenderness. | :*Acute pyelonephritis is a common clinical diagnosis in patients who present with fever, chills, and flank tenderness. | ||
:*Infections typically result from ascending retrograde spread through the collecting ducts into the renal parenchyma. | :*Infections typically result from ascending [[retrograde]] spread through the collecting ducts into the renal [[parenchyma]]. | ||
:*Patients are referred for [[CT]] evaluation of acute pyelonephritis when symptoms are poorly localized or complications are suspected. | :*Patients are referred for [[CT]] evaluation of acute pyelonephritis when symptoms are poorly localized or complications are suspected. | ||
* '''Chronic Pyelonephritis''' | * '''Chronic Pyelonephritis''' | ||
:*Chronic pyelonephritis is a somewhat controversial disease from a pathogenetic standpoint. It is unclear that, whether it is an active chronic infection, arises from multiple recurrent infections, or represents stable changes from a remote single infection. | :*Chronic pyelonephritis is a somewhat controversial disease from a pathogenetic standpoint. It is unclear that, whether it is an active chronic infection, arises from multiple recurrent infections, or represents stable changes from a remote single infection. | ||
:*[[Hypertension]] is frequently a long-term sequela. | :*[[Hypertension]] is frequently a long-term sequela. | ||
* '''Emphysematous Pyelonephritis''' | * '''[[Emphysematous]] Pyelonephritis''' | ||
:* Emphysematous pyelonephritis represents a severe life-threatening infection (overall mortality rate of approximately 50%) of the renal parenchyma with gas-forming bacteria. | :* Emphysematous pyelonephritis represents a severe life-threatening infection (overall mortality rate of approximately 50%) of the renal parenchyma with gas-forming bacteria. | ||
:* Underlying poorly controlled [[diabetes mellitus]] is present in up to 90% of patients who develop emphysematous pyelonephritis. | :* Underlying poorly controlled [[diabetes mellitus]] is present in up to 90% of patients who develop emphysematous pyelonephritis. | ||
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* '''Xanthogranulomatous Pyelonephritis''' | * '''Xanthogranulomatous Pyelonephritis''' | ||
:*Xanthogranulomatous pyelonephritis (XGP) is a rare inflammatory condition usually secondary to chronic obstruction caused by [[nephrolithiasis]] and resulting in infection and irreversible destruction of the renal parenchyma. | :*Xanthogranulomatous pyelonephritis (XGP) is a rare inflammatory condition usually secondary to chronic obstruction caused by [[nephrolithiasis]] and resulting in infection and irreversible destruction of the renal parenchyma. | ||
:*XGP is associated with a staghorn calculus in approximately 70% of cases. | :*XGP is associated with a staghorn [[calculus]] in approximately 70% of cases. | ||
:*Patients with diabetes are particularly predisposed to the formation of XGP. | :*Patients with diabetes are particularly predisposed to the formation of XGP. | ||
:*Treatment is [[nephrectomy]]. | :*Treatment is [[nephrectomy]]. | ||
:*At histologic analysis, the inflammatory mass is composed of lipid-laden macrophages and chronic inflammatory cells. | :*At histologic analysis, the [[inflammatory]] mass is composed of lipid-laden macrophages and chronic inflammatory cells. | ||
==References== | ==References== | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Nephrology]] | |||
[[Category:Inflammations]] | |||
[[Category:Disease]] | |||
Revision as of 14:44, 27 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Classification
There are four different types of pyelonephritis:
- Acute Pyelonephritis
- Acute pyelonephritis is a common clinical diagnosis in patients who present with fever, chills, and flank tenderness.
- Infections typically result from ascending retrograde spread through the collecting ducts into the renal parenchyma.
- Patients are referred for CT evaluation of acute pyelonephritis when symptoms are poorly localized or complications are suspected.
- Chronic Pyelonephritis
- Chronic pyelonephritis is a somewhat controversial disease from a pathogenetic standpoint. It is unclear that, whether it is an active chronic infection, arises from multiple recurrent infections, or represents stable changes from a remote single infection.
- Hypertension is frequently a long-term sequela.
- Emphysematous Pyelonephritis
- Emphysematous pyelonephritis represents a severe life-threatening infection (overall mortality rate of approximately 50%) of the renal parenchyma with gas-forming bacteria.
- Underlying poorly controlled diabetes mellitus is present in up to 90% of patients who develop emphysematous pyelonephritis.
- Patients present clinically with varying degrees of renal failure, lethargy, acid-base irregularities, and hyperglycemia.
- E coli is the causative bacterial source in approximately 70% of cases
- Xanthogranulomatous Pyelonephritis
- Xanthogranulomatous pyelonephritis (XGP) is a rare inflammatory condition usually secondary to chronic obstruction caused by nephrolithiasis and resulting in infection and irreversible destruction of the renal parenchyma.
- XGP is associated with a staghorn calculus in approximately 70% of cases.
- Patients with diabetes are particularly predisposed to the formation of XGP.
- Treatment is nephrectomy.
- At histologic analysis, the inflammatory mass is composed of lipid-laden macrophages and chronic inflammatory cells.