What is Xanthogranulomatous pyelonephritis?

Xanthogranulomatous pyelonephritis is an uncommon chronic destructive granulomatous process of renal parenchyma in association with long-term urinary tract obstruction and infection. It affects females more often than males, with a wide range of age, from newborn to elderly.

What causes Xanthogranulomatous pyelonephritis?

Xanthogranulomatous pyelonephritis is the inflammatory sequela of a suppurative pyogenic infection in an obstructed kidney, usually caused by staghorn calculi (70% of cases). It is usually unilateral, and Proteus species and E. coli are the most common infective agents.

What is the most common cause of pyelonephritis?

The main cause of acute pyelonephritis is gram-negative bacteria, the most common being Escherichia coli. Other gram-negative bacteria which cause acute pyelonephritis include Proteus, Klebsiella, and Enterobacter.

Is bilateral pyelonephritis curable?

Treating pyelonephritis

Although drugs can cure the infection within 2 to 3 days, the medication must be taken for the entire prescription period (usually 10 to 14 days). This is true even if you feel better. The antibiotic options are: levofloxacin.

What does Pyonephrosis mean?

Pyonephrosis—pus in the renal pelvis—results from urinary tract obstruction in the presence of pyelonephritis. Purulent exudate (inflammatory cells, infectious organisms, and necrotic, sloughed urothelium) collects in the hydronephrotic collecting system (“pus under pressure”) and forms an abscess.

What is Xanthogranulomatous mastitis?

Xanthogranulomatous mastitis is an uncommon finding. It is typically found in adult females in the 2nd-7th decades. It is characterized by the presence of multi-nucleated giant cells, lipid-laden macrophages (also called xanthoma cells or foamy histiocytes) and cholesterol crystals.

What is Xanthogranulomatous cholecystitis?

Xanthogranulomatous cholecystitis is a rare benign inflammatory disease of the gallbladder that may be misdiagnosed as carcinoma of the gallbladder on imaging [1-3].

What are the classic signs of pyelonephritis?

Classic symptoms of pyelonephritis include a sudden onset of chills, fever (body temperature of 38 °C or greater), and unilateral or bilateral flank pain with costovertebral tenderness. These signs are usually accompanied by dysuria, urinary frequency, and urgency.

How long does pyelonephritis take to heal?

Usually, you’ll start to feel better quite soon after treatment starts. Most people who are diagnosed and treated promptly with antibiotics feel completely better after about 2 weeks. People who are older or have underlying conditions may take longer to recover.

Who is at risk for pyelonephritis?

Although pyelonephritis can occur among any group of people, young women are most at risk, particularly between the ages of 15 and 29. This may have to do with the role of frequent sexual intercourse in introducing bacteria to the exterior opening of the urethra and from there to the bladder.

What is the difference between UTI and pyelonephritis?

A urinary tract infection is inflammation of the bladder and/or the kidneys almost always caused by bacteria that moves up the urethra and into the bladder. If the bacteria stay in the bladder, this is a bladder infection. If the bacteria go up to the kidneys, it is called a kidney infection or pyelonephritis.

What does pyelonephritis pain feel like?

Frequent, painful urination. Back, side (under the ribs), and groin pain. Chills and high fever. Nausea and vomiting.

How is pyelonephritis caused?

Most often, the infection is caused by bacteria that normally live in your bowel. The urinary tract has several ways to prevent infection from moving up the urinary tract. For example, urination most often flushes out bacteria before it reaches the bladder.

What is the best treatment for pyelonephritis?

Outpatient oral antibiotic therapy with a fluoroquinolone is successful in most patients with mild uncomplicated pyelonephritis. Other effective alternatives include extended-spectrum penicillins, amoxicillin-clavulanate potassium, cephalosporins, and trimethoprim-sulfamethoxazole.

Can pyelonephritis go away on its own?

Usually, the signs and symptoms of a kidney infection begin to clear up within a few days of treatment. But you might need to continue antibiotics for a week or longer. Take the entire course of antibiotics recommended by your doctor even after you feel better.

Is pyelonephritis an emergency?

While the majority of patients with pyelonephritis can be discharged from the emergency department, admission should be considered in the following instances: Unstable vital signs, e.g. persistent tachycardia, hypotension, tachypnea, or signs of septic shock.

Where is pain with pyelonephritis?

Back, side (flank) or groin pain. Abdominal pain. Frequent urination. Strong, persistent urge to urinate.

Is acute pyelonephritis life threatening?

Acute pyelonephritis is a bacterial infection of the kidney parenchyma that can be organ- and/or life-threatening and that often leads to scarring of the kidney. The bacteria in these cases have usually ascended from the lower urinary tract, but may also reach the kidney via the bloodstream.

Does pyelonephritis require hospitalization?

Outpatient Treatment. Most cases of uncomplicated acute pyelonephritis can be managed in the outpatient setting. However, patients who appear ill may have severe pyelonephritis or a complication of acute pyelonephritis and should be considered for hospitalization and further evaluation (Table 514).

How do you know a kidney infection is getting worse?

You have symptoms that a kidney infection is getting worse. These may include: Pain or burning when you urinate. A frequent need to urinate without being able to pass much urine.

What is strongest antibiotic for kidney infection?

Commonly used antibiotics for kidney infections include ciprofloxacin, cefalexin, co-amoxiclav or trimethoprim. Painkillers such as paracetamol can ease pain and reduce a high temperature (fever). Stronger painkillers may be needed if the pain is more severe.

Does pyelonephritis show up on CT scan?

CT can also show evidence of chronic pyelonephritis including renal scarring, atrophy and cortical thinning, hypertrophy of residual normal tissue, calyceal clubbing or dilatation, and renal asymmetry [2]. However, CT should not be obtained early in uncomplicated cases.

How is pyelonephritis diagnosed?

Two common laboratory tests are performed to diagnose kidney infections (pyelonephritis). A urine sample is examined under a microscope to determine if white and/or red blood cells are present. The urine is also sent to the lab to see if bacteria grow in a urine culture.

What is the most common bacterial cause for urinary tract infections?

The most common bacteria found to cause UTIs is Escherichia coli (E. coli). Other bacteria can cause UTI, but E.