[Clinico-statistical study of pyelitis in pregnancy].
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The effect of bacterial piliation on the infectivity of Klebsiella pneumoniae in the renal pelvis was examined by means of piliated and nonpiliated variants derived from a single parent strain. Piliated-phase variants were significantly more infective as determined by viable counts of bacteria isolated from the kidneys at the time of sacrifice. In addition, scanning electron microscope was used to examine the renal pelvis for evidence of infection. Kidneys infected with piliated-phase organisms exhibited greater tissue damage -- both in the magnitude of tissue alterations observed and in the number of kidneys affected. Thus, it is concluded that piliation contributes to the ability of K. pneumoniae to infect the renal pelvis following reflux from the bladder.
This is the first report of death due to gross encrustations of the entire upper urinary tract and bladder by Corynebacterium group D2 in a man with no history of renal transplantation or prolonged catheterizations. This case demonstrates that debilitated patients with a prior endoscopic procedure are at risk for this disease process. Prolonged treatment with appropriate antibiotics, acidification of the urine, and removal of crusts is essential for proper management.
We report on two new cases of encrusted pielitis, a lithiasic disease of infectious ethiology--Corynebacterium of D group-. The clinic diagnostic is difficult and this disease develops in immunosuppressed patients, mainly in renal transplanted ones. One of our two cases is diagnosed in a patient with a transplanted kidney and the other one develops the disease within her native kidneys. We remark on the clinic features and therapeutic options.
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