Emphysematous pyelitis presenting as an acute abdomen in an end-stage renal disease patient treated with peritoneal dialysis.
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[Treatment of pyelitis gravidarum with pivmecillinam].
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Amdinocillin↗
[On the pathogenesis of the cystic pyelitis].
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Chronic Disease↗
[Late sequelae of pyelitis gravidarum].
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Adult↗
Should we get routine urothelial biopsies in every stone surgery?
Physical traumas have been implicated as intrinsic risk factors for the progression of urothelial tumours. In stone disease, histologic changes of the urothelium have a wide spectrum. We want to show the importance of biopsies for identification of these changes. In this study, we investigated the histologic changes of the urothelium in stone patients. There were 16 squamous metaplasia, 14 pyelitis follicularis, 5 pyelitis or ureteritis cystica, 4 polypoid pyelitis or ureteritis, 2 encrusted pyelitis in 43 stone patients, and 5 calcium, 2 long-standing struvite and 2 mixed calculi histories were found in 9 of 14 upper urothelial tumour patients. According to our results, it is important to identify the histologic changes of the upper urothelium during stone surgery for possible neoplastic progression in the future. If any suspicious finding is demonstrated, the patients should be enrolled in a follow-up programme or should be transferred to tumour treatment programme. Therefore, we propose to take biopsies of the urothelium in every stone surgery.
Adolescent↗
Histopathologic-microbiologic correlates of invasiveness in a mouse model of ascending unobstructed urinary tract infection.
To clarify the usefulness of histopathology in evaluating invasiveness during acute cystitis and pyelonephritis in a mouse model of urinary tract infection, findings from bladder and kidney sections of mice inoculated transurethrally with Escherichia coli were compared with results of bladder, kidney, spleen, and blood cultures and with changes in peripheral blood leukocyte counts. All of the 14 bladder histopathologic abnormalities evaluated were significantly associated with a positive bladder culture, and 7 were associated with splenic infection. Histopathologic features of cystitis were present in some culture-negative bladders. Eleven of 12 renal histopathologic abnormalities evaluated were significantly associated both with a positive kidney culture and with splenic infection, and two correlated with the development of peripheral leukocytosis. Histopathologic features of pyelitis and nephritis permitted culture-positive kidneys to be categorized as exhibiting colonization only, pyelitis only, or pyelitis plus frank nephritis and demonstrated that some culture-negative kidneys exhibit signs of pyelitis and nephritis. These findings suggest that detailed, semiquantitative histopathologic evaluation can add to quantitative cultures in the assessment of bacterial urovirulence in the mouse model of ascending urinary tract infection.
Animals↗
Renal pelvic biopsies of renal calculi patients.
Histological alterations in the renal pelves of 32 patients operated on for renal stone(s) were investigated in this prospective study. It was demonstrated that there were five cases of squamous metaplasia, two cases each of pyelitis cystica, pyelitis follicularis and polypoid pyelitis, and one case each of papillary adenocarcinoma, transitional cell carcinoma and encrusted pyelitis. The results obtained suggest that renal pelvic biopsy should be a routine procedure during open or percutaneous renal surgery.
Biopsy↗
[Corynebacterium urealyticum in renal trasplantation. CT and sonography imaging characteristics of encrusted cistitis and pielitis].
PURPOSE: Its described three cases of Corynebacterium urealyticum (CU) infection in patients with renal transplantation and one of its most serious consequences: encrusted pyelitis and cystitis. It is explained the principal keys for its diagnosis, based in the appearance of alkaline pH in in urine analysis (alkaline urine), positives urinary cultures for CU, and the CT and US studies revealed the characteristic images of calcifications in the wall of renal pelvis and bladder. PATIENTS: Three male patients with renal transplantation and CU infection that caused encrusted pyelitis in two of the cases and encrusted cystitis in one case. RESULTS: Calcifications of the urinary tract were noticed in CT in all the patients. In two cases bladder stones were linear, and in the third case they were fundamentally coarse and placed in pelvis. The diagnosis suspicion showed by the images was confirmed by the use of prolonged urine cultures, necessary for detecting CU. All the patients were treated with vancomycin, with success in two of the cases and, finally needing surgery, and after loss of the graft, in the other case. CONCLUSION: Encrusted pyelitis and cystitis are cronic and severe infections of the urinary tract. Calcic struvite incrustations in the urothelium are characteristics of this infection. CT is a choice technique for the diagnosis and followup of the calcifications after treatment.
Adult↗
COMMON UROLOGICAL CONDITIONS IN THE FEMALE.
Stress incontinence, urge incontinence, and pyelitis of pregnancy are common urological conditions in the female. Poor therapeutic results in the treatment of stress incontinence may be traced to errors in diagnosis. Accurate diagnosis is based on an accurate history, residual urine test, the stress test, cystometric studies (to rule out neurogenic disturbances), cystourethroscopy and cystourethrography. The most important factor in the production of urge incontinence is infection. Some pathological conditions which may be associated with urge incontinence are urethritis, cystitis, urethral stricture, bladder-neck obstruction, urethral diverticula, urethral caruncle and the urgencyfrequency syndrome. Therapy is directed toward the eradication of infection and treatment of the specific lesion. In pyelitis of pregnancy it is urged that, in cases of unusual bacterial virulence and poor ureteral drainage, early cystoscopic ureteral catheter drainage should be instituted in order to prevent permanent kidney damage. The closest co-operation of urologist, gynecologist and general physician is necessary for clarification of some of the more complex problems.
Cystitis↗
Microscopic and ultrastructural lesions of the ureter and renal pelvis in sows with regard to Actinobaculum suis infection.
Tissues from ureter and renal pelvis of 18 sows naturally (n = 15) and experimentally (n = 3) infected with Actinobaculum suis (former Actinomyces, Eubacterium suis) were studied using light and scanning as well as transmission electron microscopy. The results were compared with the findings from 11 clinically healthy sows as controls. The lesions in both the ureter and renal pelvis of naturally and experimentally infected animals were similar. In severe cases there were necrotizing ureteritis and pyelitis with accumulation of bacterial colonies in some cases. Several superficial epithelial cells were found phagocytosing necrotic debris. In mild cases the main lesions included epithelial cell hyperplasia, desquamation of the superficial epithelial cells and goblet cell metaplasia with intraepithelial cyst formation. The goblet cells were found in the superficial as well as in the intermediate cell layers. Generally, it was observed that severe purulent ureteritis and pyelitis/ pyelonephritis in sows were to be expected only in mixed infection of A. suis with other bacteria. The findings were compared and discussed with the changes in the infected urinary bladder of sows and the alterations induced by urinary tract infection in man.
Actinomyces↗
Urothelial changes of the renal papillae in Sprague-Dawley rats induced by long term feeding of phenacetin.
Thirty female Sprague-Dawley rats were fed 0.535 per cent phenacetin in the diet for up to 110 weeks. Twenty-six of these rats developed urothelial hyperplasia, partly papillary, of the renal papillae. Twenty-eight rats showed dilatation of the vasa recta frequently associated with thrombus formation and calcification. One phenacetin fed rat had epithelial hyperplasia associated with chronic pyelitis. In 2 of the 30 control rats urothelial hyperplasia was found to be associated with chronic pyelitis. The hyperplastic urothelial changes and vascular changes were often, but not always, present simultaneously. One control rat developed a mammary carcinoma, as compared with 5 rats in the phenacetin group. Four phenacetin fed rats developed carcinoma of the ear duct. The results of the present investigation provide evidence that phenacetin can induce proliferative lesions of the urothelium of the rat renal pelvis with weak carcinogenic activity in the ear duct and mammary glands.
Animals↗
Experimental Escherichia coli O6 pyelonephritis in rabbits. Effect on O6 antibody quantity and avidity of prior immunization with E. coli O2 bacteria.
Haematogenous pyelonephritis was induced in rabbits using Escherichia coli 06:K13:H1 bacteria and the amounts and avidities of antibodies to the 06 antigen were analysed by the ammonium sulphate precipitation technique of Farr. In a group of six animals preimmunized with E. coli 02:K2ab:H1, five developed pyelonephritis and one pyelitis, as determined by histological examination. All aminals showed a considerable antibody response to E. coli 06 antigen during the infection. The animal with pyelitis gave a slightly smaller response than the others. The antibody avidity showed a pronounced variation. In a second group of six rabbits not preimmunized, five animals developed pyelonephritis. The titres of antibodies against E. coli 06 antigen increased during the infection inall of the six animals. However, the increase was significantly smaller than for the animals preimmunized with E. coli 02:K2ab:H1 (P smaller than 0.01). The pattern of the antibody avidities in this group was also heterogenous. The results are consistent with previous findings that exposure to serologically heterologous E. coli bacteria can enhance the development of the homologous antibody titres. This could be of relevance for serological diagnostic work as well as in the determination of the protective capacity of the antibody.
Ammonium Sulfate↗
Haemolytic Escherichia coli in etiopathogenesis of pyelonephritis in rats--an experimental study.
Of the 26 urinary E. coli strains employed in the present study, 16 were haemolytic and 10 were non haemolytic in character. Of the 16 haemolytic strains injected through the exposed femoral vein of the rats, 12 showed the lesions of pyelitis, pyelonephritis and proliferation of glomerular tuft while 2 showed only the lesions of pyelitis and pyelonephritis. It was interesting to note that none of the nonhaemolytic strains produced any lesion in the animal. The data demonstrated a positive correlationship between haemolytic activity of E. coli and pyelonephritis in rats.
Animals↗
Fatal septic shock caused by Corynebacterium D2.
BACKGROUND: Septic shock remains one of the leading causes of mortality in critically ill patients. Optimal management depends on prompt diagnosis with identification of the causative organisms to allow appropriate antibiotic therapy. PATIENT: We report the first case of septic shock caused by Corynebacterium D2, a micro-organism that can cause encrusted cystitis and pyelitis of transplanted kidneys or, more rarely, native kidneys. Diagnosis rests on identification of risk factors, positive urine cultures, and computed tomography results. Despite optimal treatment our patient died with persistent encrusted pyelitis. CONCLUSIONS: Corynebacterium D2 is known to cause chronic inflammation of the bladder and proximal urinary tract but can also cause severe septic shock in immunocompetent patients.
Aged↗
[Encrusted prostatitis: case report and literature review].
We report a case of encrusted prostatitis, term which is not found in MedLine search. Alkaline encrusted cystitis was described 70 years ago and few cases have been described since that time, most of them associated with Corynebacterium infection. In fact, we find these two entities very similar, except for the organ affected. Both present irritative urinary symptoms, alkaline urine and tisular necrosis below a calcification layer. Another entity described in 1993 is encrusted pyelitis, related to patients with immunodeficiency, particularly those with renal transplantation and also associated with ureolytic bacteria. The treatment of encrusted cystitis an pyelitis may include specific antibiotics, urinary acidification and endoscopic excision of the calcified lesions.
Aged↗
Epithelial abnormalities in the renal pelvis in experimental hydronephrosis and pyelonephritis.
Unilateral hydronephrosis was induced by temporary ligature of the left ureter in 29 rabbits. In 21 animals so treated, chronic pyelonephritis was simultaneously induced by intravenous application of a suspension of E. coli. Histologic examination of renal pelvic epithelia in animals killed four weeks after the surgical intervention, revealed the following features: 1. Simple hyperplasia of urothelium in 12 cases, 2. atypical hyperplasia - (dysplasia) of urothelium in 10 cases, 3. v. Brunn's nests in 20 renal pelvises; 11 cases of cystic pyelitis, all combined with Brunn's nests, 4. metaplastic transformation of visceral mono- or bilayered epithelium into multi-layered urothelium-like structures in 19 renal pelvises. These changes are observed almost exclusively in the left renal pelvis of animals subjected to temporary ureteral ligature. Atypical urothelial hyperplasia is found only together with chronic pyelonephritis. Hyperplastic and dysplastic epithelial changes in the renal pelvis, the formation of Brunn's nests, and cystic pyelitis are interpreted as sequelae of postrenal obstruction or concomitant chronic inflammation.
Animals↗
O-acetylated sialic acid variants in intestinal glandular metaplasia of the urinary tract.
Two cases of chronic cystitis, two of chronic ureteritis, one of chronic pyelitis and two transitional cell carcinomas of the urinary tract showed glandular metaplasia or focal mucin production. Positive staining for O-acetylated sialic acid variants (sites 7 and 8) detected by the PB-KOH-PAS method was found in the two cases of cystitis, in one of chronic ureteritis and in one of chronic pyelitis. Positive staining was observed only in areas showing an intestinal type of metaplasia and in which goblet cells and argyrophil cells were also identified. These findings taken together with earlier studies on ovarian cystadenomas lead the authors to believe that O-acetylated variants are markers of an intestinal type of epithelium. Evaluation of O-acetylated sialomucins may be useful in further studies on the histogenesis of primary adenocarcinomas of the bladder.
Adult↗
Mucinous cystadenoma with malignant transformation arising in the renal pelvis.
Mucinous cystadenoma with malignant transformation occupying the lower half portion of the right renal pelvis in a 69-year-old Japanese man was recorded. The patient had recent dysuria but no clinical history of pyelonephritis or urolithiasis. Under the clinical diagnosis of unusual renal cyst, the right total nephrectomy was performed. Grossly, the cystic tumor, 5 cm across, formed a monolocular lumen filled with mucins and showed no direct communication with the renal pelvis inside. Microscopically, the epithelial lining was characterized by a single layer of benign mucin producing columnar cells that scattered foci of non-invasive papillary projections with cell stratification and nuclear atypia suggestive of malignancy. Although there was non-specific chronic pyelitis, no pyelitis cystica et glandularis was encountered. Of circa 60 glandular neoplasms arising in the renal pelvis reported previously, adenomas are only five including two mucinous cystadenomas, while the remainder are adenocarcinomas. The histological findings of mucinous cystadenoma in the present case may represent the process of a transition from adenoma to adenocarcinoma. The result suggests the possibility that adenoma-carcinoma sequence may exist among the glandular neoplasma arising in the renal pelvis. The histogenesis was unclarified.
Aged↗