Predicting need for intensive care unit admission in adult emphysematous pyelonephritis patients at emergency departments: comparison of five scoring systems
This study assesses the performance of National Early Warning Score (NEWS), Quick Sepsis-related Organ Failure Assessment (qSOFA), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), and Rapid Acute Physiology Score (RAPS) in predicting emphysematous pyelonephritis (EPN) patients'need for intensive care unit (ICU) admission. A retrospective analysis was conducted at four training and research hospitals'emergency departments (EDs) on all EPN adult patients from January 2007 to August 2017. In this multicentre ED EPN series, we recommend using NEWS in early identification of critical EPN patients and advance planning for ICU admission. This would reduce delays in ICU transfer and ultimately improve patient outcomes.
FETROJA is used to treat adults who have a complicated urinary tract infection (abbreviated as cUTI) including infection of the kidneys (pyelonephritis) caused by specific bacteria. It should be used only when few or no other treatment options are available.
Conclusion: From our study, we infer that ESBL producers and qnr gene-possessing strains are frequently resistant to ciprofloxacin. Estimation of the MPC in the case of multidrug-resistant isolates in the clinical setup may help in treating these drug-resistant strains. PMID: 31772582 [PubMed]
CONCLUSION: Many aspects regarding urinary tract infection in children are still matters of debate, especially imaging investigation and indication of antibiotic prophylaxis. Further longitudinal studies are needed to establish tailored approach of urinary tract infection in childhood. PMID: 31783012 [PubMed - as supplied by publisher]
CONCLUSIONS: Antibiotic treatment may be effective in reducing the risk of pyelonephritis in pregnancy, but our confidence in the effect estimate is limited given the low certainty of the evidence. There may be a reduction in preterm birth and low birthweight with antibiotic treatment, consistent with theories about the role of infection in adverse pregnancy outcomes, but again, the confidence in the effect is limited given the low certainty of the evidence. Research implications identified in this review include the need for an up-to-date cost-effectiveness evaluation of diagnostic algorithms, and more evidence to learn w...
AbstractRecently, the Food and Drug Administration (FDA) issued an advisory that sodium ‐glucose cotransporter‐2 (SGLT‐2) inhibitors are associated with a risk of severe urinary tract infection (UTI) (1). They reported 19 patients with life‐threatening sepsis due to UTI and severe pyelonephritis after initiating SGLT‐2 inhibitors who required hospitalization. Some of them req uired admission to an intensive care unit or dialysis in order to treat acute renal failure.
We report the case of a 4-year-old boy who first presented with acute pyelonephritis at the age of 6 months. Diagnostic workup revealed high-grade bilateral vesicourethral reflux (VUR). At the age of 18 months, a bulking agent was used to treat bilateral VUR. Since the VUR persisted, an open bilateral Lich-Gregoir procedure was done at the age of 3 years. Immediately after surgery, he developed acute urinary retention with hydronephrosis that resolved with the placement of dwelling urinary catheter. After removal of the catheter urinary retention relapsed so placement of suprapubic urinary catheter was indicated since he d...
odríguez L PMID: 31761681 [PubMed - as supplied by publisher]
Conclusion Afebrile pregnant patients with pyelonephritis remain at risk of significant maternal morbidity. Application of the MEWC on admission identifies patients at higher risk of ICU admission. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Abstract | open access Full text
We present a death from acute pyelonephritis in a setting of hypertensive heart disease, in which the unenhanced PMCT performed before postmortem examination was able to show florid bilateral perinephric fat stranding. This PMCT finding subsequently guided the pathologist to pay special attention to the kidney and take appropriate microbiology specimens to confirm the diagnosis. Perinephric fat stranding on PMCT may be a useful sign to alert the pathologist to consider acute pyelonephritis during the postmortem examination.
Publication date: Available online 15 November 2019Source: Journal of Pediatric Surgery Case ReportsAuthor(s): I. Stoica, A. Muntean, M.B. McDermott, F.M.J. QuinnAbstractXanthogranulomatous pyelonephritis (XGP) is an uncommon chronic destructive granulomatous inflammation of the kidney that can sometimes mimic other renal pathologies like tumours or infections. For this reason, it is also called “the great imitator”.This is the case of a 7-year old girl that presented to the hospital with right hip pain and a suspicious right sided abdominal lesion, thought initially to be a Wilms’ tumour and then an appe...