Cases reported "Kidney Papillary Necrosis"

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1/13. nephrosis and papillary necrosis after pyelonephritis.

    We present a case of nephrotic syndrome complicating acute pyelonephritis in a 45-year-old man. His first attack of acute bacterial pyelonephritis had two unusual features: transient nephrotic syndrome and chronic recurrent episodes of papillary necrosis. The former, which lasted for two weeks, was characterized by edema, excretion of 7.7 g of urinary protein per 24 hours and hypoproteinemia (1.8 g per 100 ml). A percutaneous renal biopsy two weeks after the height of the nephrotic state showed normal glomeruli by light and electron microscopy and immunohistologic studies. Interstitial changes were noted. Over two years the patient has passed approximately 50 fragments, characterized as necrotic tissue containing tubular structures. He has no evidence of diabetes mellitus, urinary-tract obstruction or ureteral reflux, analgesic abuse or atypical vasculitis. He is afebrile but has recurrent bacteriuria despite antibiotics. This case demonstrates that acute pyelonephritis must be added to the list of diseases causing the nephrotic state.
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ranking = 1
keywords = pyelonephritis
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2/13. Complications of intravesical bacillus Calmette-Guerin: a case report.

    bacillus Calmette-Guerin (BCG) is the most effective agent currently available to treat superficial bladder cancer. However, this form of therapy is not without potential serious or fatal complications. In addition to the potentially toxic systemic side effects attributed to hematogenous absorption of the bacillus, direct upper tract seeding may occur in patients with vesicoureteral reflux. We report on a patient treated with intravesical BCG for bladder cancer in whom unilateral necrotizing granulomatous pyelonephritis developed. Although severe, this complication is rare and we conclude that reflux is not a contraindication for intravesical BCG therapy.
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ranking = 0.14287536269274
keywords = pyelonephritis, necrotizing
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3/13. Clinics in diagnostic imaging (99). Left emphysematous pyelonephritis.

    A 57-year-old woman, known to have diabetes mellitus, presented with a one-week history of fever, dysuria, and left flank pain. Computed tomography showed extensive left renal parenchymal destruction and a large gas collection. urine culture revealed growth of escherichia coli. The diagnosis of emphysematous pyelonephritis was confirmed at left nephrectomy. The clinical manifestations of emphysematous pyelonephritis, types of gas-forming renal infection, and their radiological findings are discussed.
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ranking = 0.85714285714286
keywords = pyelonephritis
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4/13. candida tropicalis-associated bilateral renal papillary necrosis and emphysematous pyelonephritis.

    Although the kidney is often involved in disseminated and localized candidiasis, bilateral emphysematous pyelonephritis (EPN) is infrequently reported. Renal papillary necrosis (RPN) caused by fungi is also rare. We describe a patient with bilateral RPN and EPN caused by candida tropicalis, who suffered from recurrent hematuria, flank pain, acute fulminant renal failure, and obstruction by a sloughed papilla. He was treated successfully with antifungal therapy and percutaneous nephrostomy (PCN). This is the first case report of C. tropicalis-associated EPN and RPN.
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ranking = 0.71428571428571
keywords = pyelonephritis
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5/13. Emphysematous pyelonephritis: clues to rapid diagnosis in the Emergency Department.

    Emphysematous pyelonephritis (EPN) is an acute life-threatening bacterial infection. EPN leads to rapid necrotizing destruction of the renal parenchyma and peri-renal tissue, requiring early and aggressive care to reduce morbidity and mortality. Previous studies have described the use of computed tomography scan and radiology-performed ultrasound to make the diagnosis of EPN We report a case of EPN diagnosed by bedside Emergency Department (ED) ultrasound performed by emergency physicians, allowing a more rapid diagnosis and subsequent treatment.
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ranking = 0.71430393412131
keywords = pyelonephritis, necrotizing
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6/13. Acute renal failure due to acute pyelonephritis.

    We report a case of biopsy-proved acute pyelonephritis which caused acute renal failure. Despite appropriate antibiotic therapy, recovery of renal function was slow and incomplete. Renal papillary necrosis was an apparent complication, which the patient may have been predisposed to by alcoholism. Although rare, acute pyelonephritis is an important consideration in the differential diagnosis of acute renal failure because of the need for specific therapy.
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ranking = 0.85714285714286
keywords = pyelonephritis
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7/13. Necrotizing emphysematous pyelonephritis: a case report.

    Emphysematous pyelonephritis (EP) is comparatively rare in urological practice. From 1898 to the present time only 45 cases have been described. In this report we describe the case of a 43-year old diabetic man, with right EP without obstruction of the urinary tract and with a urinary infection of E. Coli. This appears to be rather rare as it is more frequently associated with obstruction of the urinary tract. Surgical exploration enabled us to discover a fistula between the kidney and the wall of the vena cava which would have caused fatal complications if it had not been discovered. The micro-organisms more frequently involved were E. Coli, proteus, Aerobacter and various anaerobes. mortality has been reported as 75% in patients receiving medical therapy only and 23% in those undergoing surgery. The authors therefore believe that surgical exploration even with no urinary tract obstruction makes it possible to detect complicating pathologies which may remain undiscovered by medical examination and the urinary excretory tract and renal sheath drained. This provides a better opportunity of estimating possible reversibility of the renal lesion.
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ranking = 0.71428571428571
keywords = pyelonephritis
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8/13. Simultaneous occurrence of transitional cell carcinoma and urothelial adenocarcinoma associated with xanthogranulomatous pyelonephritis.

    We report on a patient with xanthogranulomatous pyelonephritis, in situ transitional cell carcinoma, and focal prosoplasia revealing abrupt conversion of transitional epithelium to moderately well-differentiated adenocarcinoma. The etiology and pathogenesis of mucinous adenocarcinoma in the renal pelvis very likely involves the prosoplastic transition of pre-existing transitional carcinoma to adenocarcinoma. The urologist should be aware of the increased possibility of this tumor developing in a patient with longstanding infection, and frozen section should be performed more often because the gross structure of the tumor frequently appears normal. This permits the urologist to change his surgical strategy if frozen section is positive for tumor.
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ranking = 0.71428571428571
keywords = pyelonephritis
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9/13. Renal papillary necrosis and pyelonephritis accompanying fenoprofen therapy.

    Renal papillary necrosis occurred after fenoprofen calcium administration in a patient with systemic lupus erythematosus and urinary tract infection. Possible mechanisms of renal damage may be hypersensitivity, decreased blood flow, and decreased production of a prostaglandin E-like substance.
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ranking = 0.57142857142857
keywords = pyelonephritis
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10/13. Papillary necrosis associated with calyceal arteritis.

    The renal papilla has a double blood supply - from both the vasa recta and the calyceal arteries. The importance of the latter supply is not established. A case of polyarteritis associated with papillary necrosis is reported, in which the calyceal vessels, supplying the area, show acute necrotizing arteritis and occlusion. The pathophysiological and clinical implications are discussed.
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ranking = 1.8219835599206E-5
keywords = necrotizing
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