Pyelonephritis classification

Urinary Tract Infections Main Page
Pyelonephritis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Pyelonephritis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocaridogram
X Ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Interventions
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Pyelonephritis classification On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Pyelonephritis classification All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Pyelonephritis classification
CDC on Pyelonephritis classification
Pyelonephritis classification in the news
Blogs on Pyelonephritis classification
Directions to Hospitals Treating Pyelonephritis
Risk calculators and risk factors for Pyelonephritis classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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.