The Urinary System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
Since stasis allows bacterial invasion through the urinary tract, urinary stasis is frequently implicated in acute pyelonephritis, and it may arise from such underlying disorders as ureteral or urethral strictures, renal calculi ("kidney stones" formed through the process of nephrolithiasis), tumors, prostatic hypertrophy, or neurogenic bladder. Symptoms of acute pyelonephritis include fever and chills, vomiting, and bladder irritation from infected urine, causing urgency and frequency of urination (also called miction or micturition). A more descriptive term for acute pyelonephritis, although one that is less frequently used, is acute infective tubulointerstitial nephritis because it describes the infective nature of the disease and the involvement of the tubules and their interstitial spaces. The term pyelonephritis should only be applied to diseases with documented urinary tract infection (UTI).
Schistosoma haematobium
Eric S. Loker, Bruce V. Hofkin in Parasitology, 2015
Pathology As with S. mansoni, the pathology caused by S. haematobium results from eggs trapped in the tissues, in this case primarily in the bladder wall. Infections are often accompanied by hematuria (blood in the urine) (Figure 2). Long-term infection can incite squamous cell carcinoma in the bladder, a rare example of cancer induced by a eukaryotic infectious agent. Damage to the ureters can obstruct the flow of urine and cause hydronephrosis (dilation of the pelvis and calyces of the kidneys). Pyelonephritis, or bacterial infection in the kidney, is another frequent consequence of infection. Damage to the glomeruli of the kidneys resulting from deposition of immune complexes can also occur. Infection can result in lesions in the lower female genital tract, likely facilitating the spread of sexually transmitted diseases, including HIV.
What Is Diagnosis?
Pat Croskerry, Karen S. Cosby, Mark L. Graber, Hardeep Singh in Diagnosis, 2017
Depending on the setting and our own particular role in medicine, we may have widely varying ideas about what constitutes a diagnosis, and the degree of precision, accuracy, and certainty carried by a diagnostic label; examples of types of diagnoses are shown in Figure 1.1. An office-based primary care doctor may be comfortable inferring the diagnosis of urinary tract or kidney infection based on a clinical syndrome of flank pain, fever, and dysuria. If that same patient visits an Emergency Department, the diagnosis may be confirmed by urinalysis. If there is a suspicion of complicated disease, the clinician may order a computed tomography (CT) scan to rule out perinephric abscess or infected renal stone with obstruction. If admitted, a hospitalist might rest his final diagnosis on the results of a urine culture to identify the exact organism and sensitivities to antibiotics. An infectious disease researcher might require an immunofluorescence study of urinary sediment to identify antibody-coated bacteria to distinguish between upper and lower urinary tract disease. Each of these clinicians is correct, but all with varying degrees of certainty and precision. Each has a risk of being wrong if information is incomplete or results are misinterpreted.
Rotula aquatica Lour. mitigates oxidative stress and inflammation in acute pyelonephritic rats
Published in Archives of Physiology and Biochemistry, 2022
A. Vysakh, Kuriakose Jayesh, Ninan Jisha, V. Vijeesh, Sebastian Jose Midhun, Mathew Jyothis, M. S. Latha
Urinary tract infections (UTIs) are considered as one of the most common bacterial disease which experience 40% of women and 12% of men once in their life time. The pyelonephritogenic subset of Escherichia coli was accountable for up to 85% of both complicated and uncomplicated UTIs (Plotnikov et al.2013). The upper urinary tract infection (pyelonephritis) was considered as a potentially life-threatening infection that affects kidneys. If the disease is not treated properly with antibiotic therapy, acute pyelonephritis patient eventually died due to infection and renal damage. The oxidative stress and inflammatory response associated with bacterial infection (infection-induced intoxication) contribute much to kidney tissue damage. The reactive oxygen species is the only reason behind oxidative tissue injury in the pathogenesis of renal diseases, including pyelonephritis(Kaur et al.1988). Reports from E. coli-induced pyelonephritis in animal models (rats) documented that the reactive oxygen species generated from the activated neutrophils and monocytes causes oxidative renal injury by enhancing glomerular infiltration which causes the generation of altered protein, membranes, DNA, and basement membranes which ultimately result in cells and organ dysfunction(Meylan et al.1989, Allameh and Salamzadeh 2016).
Endocarditis in kidney transplant recipients: a systematic review
Published in Journal of Chemotherapy, 2021
Petros Ioannou, Konstantinos Alexakis, Diamantis P. Kofteridis
Previous studies in the general population have shown that the most frequent pathogens are Staphylococcus, Streptococcus, Enterococcus, and gram-negative microorganisms.72–74 In the present review the microbiology of IE in renal transplant recipients is different, with Enterococcus and gram-negative bacilli being frequent pathogens. Interestingly, in a recent study describing nosocomial IE, Enterococcus emerges as the most frequent pathogen.74 Thus, it seems tempting to assume that the patients with IE and kidney transplantation could have a microbiology that resembles that of the nosocomial IE, given the close relation of this population with the healthcare system. Another possible explanation for this difference in microbiology could be the frequent urinary origin of bloodstream infections in kidney transplant recipients, given their clear predisposition to pyelonephritis.75
Urinary tract infection during pregnancy: current concepts on a common multifaceted problem
Published in Journal of Obstetrics and Gynaecology, 2018
Kallirhoe Kalinderi, Dimitrios Delkos, Michail Kalinderis, Apostolos Athanasiadis, Ioannis Kalogiannidis
Urinary tract infections in pregnancy are classified as either asymptomatic or symptomatic. Asymptomatic bacteriuria is defined as the isolation of bacteria in at least 1 × 105 colony-forming units per mL of cultured urine, in the absence of signs or symptoms of a UTI. Symptomatic UTIs are divided into lower tract (acute cystitis) or upper tract (acute pyelonephritis) infections (Bahadi et al. 2010). Asymptomatic bacteriuria occurs in 2–15% of pregnant women and is a major risk factor for developing symptomatic UTIs during pregnancy (Ipe et al. 2013). The prevalence of symptomatic urine infection during pregnancy is less common, complicating about 1–2% of all pregnancies (Schnarr and Smaill 2008). Among symptomatic UTI, cystitis is defined as significant bacteriuria with associated bladder mucosal invasion, whereas pyelonephritis is defined as significant bacteriuria with associated inflammation of the renal parenchyma, calices and pelvis. The major symptoms of cystitis are dysuria, urgency and frequent urination and the affected patient may present with suprapubic tenderness. Pyelonephritis is usually accompanied by fever, lumbar pain, nausea and vomiting. If asymptomatic bacteriuria is untreated, 20–40% of cases progress to acute UTI, such as pyelonephritis and can likely cause multiple pregnancy complications, including premature delivery in 20–50% of cases (Whalley 1967; Patterson and Andriole 1997; MacLean 2001).
Related Knowledge Centers
- Acute Kidney Injury
- Costovertebral Angle Tenderness
- Dysuria
- Fever
- Pyonephrosis
- Nausea
- Polyuria
- Kidney
- Sepsis
- Pathogenic Bacteria