Professional Documents
Culture Documents
Urinary Tract Infection
Urinary Tract Infection
• Immunogenisity phagocytosis
• Treatment :
• For the functional or anatomical anomaly
Antibiotics
• Empirical therapy.
• Definitive therapy.
• Bacterial resistance to drug therapy.
Acute pyelonephritis
• Clinical Dx:
• Flank pain
• Fever.
• Elevated WBCs
• DD:
• acute cholecystitis.
• Pancreatitis.
Acute pyelonephritis
• Risk factors:
• VUR
• UTO
• Spinal cord injury
• D.M
• Malformation
• pregnancy
• FC
Acute pyelonephritis
• Pathogenisis :
• Initially patchy
• Inflammatory bands from renal papilla to
cortex.
• 80% E.coli, others klebsiella, proteus&
pseudomonas.
Acute pyelonephritis
• Urine analysis & culture.
• CBC , U&E
• KUB & ultrasoundif no response with I.V
antibiotic for 3 days go for CTU
Perinephric abscess
• Pathogenesis.
• Suspected??
• C.T, ultrasound
• PC drainage .
• Open surgical
Pyonephrosis
• Infected hydronephrosis.
• Pus accumulation
• Causes
• Ultrasound. C.T
• Management: PCN, I.V antibiotic, I.V
fluids.
Emphysematous pyelonephritis
• Severe form of acute pyelonephritis
• Gas forming organism
• Fever, abdominal pain with radiographic
evidence of gas within the kidney.
• D.M
• Urinary obstruction.
• High glucose level-------fermentation,CO2
production
Emphysematous pyelonephritis
• Presentation: sever acute pyelonephritis
• High fever & systemic upset
• E.coli, commonly,
• Klebsiella & proteus less frequent
Management
• KUB
• Ultrasound, C.T
• Patients are unwell
• Mortality is high
Management
• Conservative ?
• I.V antibiotic , IVF
• PC drainage
• Control D.M
• C.T , Ultrasound
• Stone , mass ?? RCC
Xanthogranulomatous
pyelonephritis
• IV antibiotic ,
• Nephrectomy