The clinical and imaging presentation of acute "non complicated" pyelonephritis: A new profile for an ancient disease

BMC Nephrology

Research Article

Melania Serra¹  Mauro Felice Frascisco¹  Alberto Biglino²  Marilisa Biolcati³  Giorgina Barbara Piccoli⁴  Valentina Consiglio⁴  Maria Chiara Deagostini⁴  Agostino De Pascale⁵  Andrea Veltri⁵  Francesco Porpiglia⁶  Francesca Ragni⁶ 

[1] Emergency Medicine; Department of Clinical and Biological Sciences ASOU san Luigi Gonzaga Regione Gonzole 10, University of Torino, Orbassano, Italy;Infectious Diseases Department of Clinical and Biological Sciences, Ospedale di Asti, University of Torino, Italy;Materno Foetal Unit, sant'Anna Hospital, University of Torino, Italy;Nephrology; Department of Clinical and Biological Sciences ASOU san Luigi Gonzaga Regione Gonzole 10, University of Torino, Orbassano, Italy;Radiology; Department of Clinical and Biological Sciences ASOU san Luigi Gonzaga Regione Gonzole 10, University of Torino, Orbassano, Italy;Urology; Department of Clinical and Biological Sciences ASOU san Luigi Gonzaga Regione Gonzole 10, University of Torino, Orbassano, Italy;

关键词: Acute pyelonephritis;    upper urinary tract infections;    computed tomography;    nuclear magnetic resonance;    kidney scars;    epidemiology;   

DOI  :  10.1186/1471-2369-12-68

 received in 2011-04-11, accepted in 2011-12-15,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundAcute pyelonephritis (APN) is differently defined according to imaging or clinical criteria. In adults information on the relationship between imaging and clinical data is lacking.Our study was aimed at analysing the relationship between the clinical and imaging presentation of APN, defined according to imaging criteria (parenchymal involvement at MR or CT scan).MethodsAll consecutive patients hospitalized for "non-complicated" APN were considered (June 2005-December 2009). Clinical, biochemical and imaging data at hospitalization were analyzed by univariate and logistic regression analysis.ResultsThere were 119 patients, all females, median age 32 years (15-72). At hospitalization, inflammatory markers were elevated (CRP median: 12.1 mg/dL, normal < 0.8). Incomplete presentations were frequent: fever was absent in 6.7%, pain in 17.8%, lower urinary tract symptoms in 52.9%. At CT or MR scan the lesions were bilateral in 12.6%, multiple in 79.8%; abscesses were present in 39.5%. Renal scars were found in 15.1%. Positive cultures were correlated with multiple foci (multivariate OR 4.2; CI 1.139-15.515). No other sign/symptom discriminated between small lesions, abscesses or multifocal involvement.ConclusionsAPN is a protean disease. In the absence of strict correlation with clinical or biochemical markers, imaging studies are required to assess the severity of kidney involvement.

【 授权许可】

CC BY   
© Piccoli et al; licensee BioMed Central Ltd. 2011