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Pain
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Kidney pain − ipsilateral costovertebral angle just beneath the 12th rib.Radiate across the flank anteriorly towards the upper abdomen and groin.Mechanoreceptors − activated by increased renal pressure.Chemoreceptors − activated by inflammation/ischaemia.
Urinary tract infections in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Unlike its usual precursor ASB, pyelonephritis is nearly always diagnosed clinically. Patients typically present with the symptoms of back pain and chills (82%); approximately one-quarter have nausea and vomiting. An elevated temperature is uniformly present, with a temperature of ‡40°C in 12% of patients. The majority of patients have costovertebral angle tenderness (predominantly right sided or bilateral) (1). Because none of these signs or symptoms is pathognomonic for pyelonephritis, the final diagnosis should depend on a urine culture positive for a known uropathogen.
Unexplained Fever In Urology
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
In the majority of patients, no local physical findings are present, while costovertebral angle tenderness may be elicited in some and palpable abdominal mass and crepitus in tissues overlying the affected kidney may exist in a few. The latter finding usually presages a dismal outcome.
A randomized, active-controlled, multicentre clinical trial to evaluate the efficacy and safety of oral sitafloxacin versus levofloxacin in Chinese adults with acute uncomplicated or complicated urinary tract infection
Published in Annals of Medicine, 2021
Ying Li, Yousheng Yin, Xiaomei Peng, Hongguang Zheng, Fajun Fu, Zhenxiang Liu, Xiongfei Wu, Xiaoyan Wu, Song Zheng, Nan Chen, Leye He, Laicheng Ren, Zhaohui Ni, Detian Li, Peiyu Liang, Xiaoju Lv, Yingyuan Zhang
In FAS analysis, the patients were comparable between sitafloxacin group and levofloxacin group in terms of age, sex, body weight, height and body mass index. The main underlying diseases in FAS were hypertension, diabetes mellitus, nephrolithiasis and glomerular nephritis (Table 1). Febrile symptom was present in 8.8% (3/34) of the patients in sitafloxacin group and 23.3% (7/30) of the patients in levofloxacin group. The common clinical symptoms and signs included lower urinary tract symptoms (frequent urination, urinary urgency, painful urination), urinary stuttering, post micturition dribble, lower abdominal discomfort/pain, flank pain and costovertebral angle tenderness or percussion pain. The underlying diseases and UTI-related symptoms and signs were comparable at baseline between sitafloxacin group and levofloxacin group. The results in PPS were similar to FAS analysis.
Renal and perinephric abscesses involving Lactobacillus jensenii and Prevotella bivia in a young woman following ureteral stent procedure
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Abhinav Mohan, Jacob Rubin, Priyank Chauhan, Juan Lemos Ramirez, German Giese
In the emergency department, she presented with fevers (38.3 ⁰C) and tachycardia (117). Significant right abdominal and costovertebral angle tenderness were present on the exam. Complete blood count showed mild leukocytosis (11.4). Urinalysis showed rare bacteria with negative leukocyte esterase, and urine culture was negative. CT abdomen/pelvis with contrast showed enlarged right kidney with a 4 cm renal cyst, as well as a complicated right-sided perinephric fluid collection, suspicious for abscess or hematoma (Figure 1). She was admitted for sepsis and started on cefepime and vancomycin. A percutaneous drain was placed into the renal cyst, and purulent fluid was removed. Cultures of the drained fluid grew Lactobacillus, Streptococcus viridans species, and ‘mixed anaerobes’. Blood cultures grew Lactobacillus jensenii on anaerobic media. This was confirmed by both rapid ANA sequencing and MALDI-TOF Mass Spectrometry.
Robot-assisted radical nephrectomy for primary renal mesenchymal chondrosarcoma: case report and literature review
Published in Renal Failure, 2019
Wen Deng, Jinxiu Zhou, Xiaoqiang Liu, Luyao Chen, Guanghua Guo, Bin Fu
A 62-year-old man, with no significant medical history, was hospitalized with left loin pain and intermittent gross hematuria. Nothing except for mild costovertebral angle tenderness was found abnormal on routine physical examination. The laboratory tests including hematologic studies and urinalysis are shown in Table 1. Abdominal contrast-enhanced CT scan revealed a 14 cm × 11 cm × 8 cm heterogeneous lobulated mass, which involved most of the left renal parenchyma, with the calcification foci and cystic spaces. Multiple patchy dense calcifications occupying the expanded renal pelvis and bar filling defect in left renal vein were also detected in the CT scan (Figure 1). A 0.7 cm lung nodule was identified at the left upper lobe on the chest X-ray. In a bone scan, nuclide was distributed evenly and meristicly over the body except for the 7th thoracic vertebra, which was considered as a metastatic lesion.