Pyelonephritis - Revision history

Rossdonaldson1: /* Admission */

2022-04-20T22:03:31Z

Admission

← Older revision		Revision as of 22:03, 20 April 2022
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	*Immunocompromised		*Immunocompromised
	*Unable to tolerate PO		*Unable to tolerate PO
	*Pregnancy		*[[Pregnancy]]
	*Solitary kidney or other anatomic abnormality		*Solitary kidney or other anatomic abnormality

2022-04-20T22:03:03Z

Disposition

← Older revision		Revision as of 22:03, 20 April 2022
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	==Disposition==		==Disposition==
	===Discharge===		===Discharge===
	**Consider if young, otherwise healthy, tolerating PO		*Consider if young, otherwise healthy, tolerating PO

	===Admission===		===Admission===
	*Consider admission if:<ref>Norris DL, Young JD. UTI. EM Clin N Am. 2008; 26:413-30.</ref>		Consider admission if:<ref>Norris DL, Young JD. UTI. EM Clin N Am. 2008; 26:413-30.</ref>
	**Elderly (>60)		*Elderly (>60)
	**[[Renal Calculi]]		*[[Renal Calculi]]
	**Obstruction		*Obstruction
	**Recent hospitalization/instrumentation		*Recent hospitalization/instrumentation
	**[[DM]]		*[[DM]]
	**Immunocompromised		*Immunocompromised
	**Unable to tolerate PO		*Unable to tolerate PO
	**Pregnancy		*Pregnancy
	**Solitary kidney or other anatomic abnormality		*Solitary kidney or other anatomic abnormality

	==Disposition==		==Disposition==

2022-04-20T22:02:35Z

Disposition

← Older revision		Revision as of 22:02, 20 April 2022
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	==Disposition==		==Disposition==
	*Discharge		===Discharge===
	**Consider if young, otherwise healthy, tolerating PO		**Consider if young, otherwise healthy, tolerating PO

			===Admission===
	*Consider admission if:<ref>Norris DL, Young JD. UTI. EM Clin N Am. 2008; 26:413-30.</ref>		*Consider admission if:<ref>Norris DL, Young JD. UTI. EM Clin N Am. 2008; 26:413-30.</ref>
	**Elderly (>60)		**Elderly (>60)

2022-04-20T22:01:53Z

Workup

← Older revision		Revision as of 22:01, 20 April 2022
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	*[[Urine culture]]		*[[Urine culture]]
	*Consider imaging (CT or [[renal ultrasound\|ultrasound]]) if any of the following:		*Consider imaging (CT or [[renal ultrasound\|ultrasound]]) if any of the following:
	**''CT sensitivity 72%, specificity 58%''		**''CT sensitivity 72%, specificity 58%<ref>Perirenal fat stranding is not a powerful diagnostic tool for acute pyelonephritis
			International Journal of General Medicine</ref>''
	**History of [[Renal Stone]]		**History of [[Renal Stone]]
	**Poor response to [[antibiotics]]		**Poor response to [[antibiotics]]

2022-04-20T21:53:51Z

Evaluation

← Older revision		Revision as of 21:53, 20 April 2022
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	[[File:Pyuria2011.jpg\|thumb\|Urine with pyuria.]]		[[File:Pyuria2011.jpg\|thumb\|Urine with pyuria.]]
	[[File:Ultrasonography of acute pyelonephritis.jpg\|thumb\|[[Renal ultrasound]] showing acute pyelonephritis with increased cortical echogenicity and blurred delineation of the upper pole.<ref>Content initially copied from: Hansen, Kristoffer; Nielsen, Michael; Ewertsen, Caroline (2015). "Ultrasonography of the Kidney: A Pictorial Review". Diagnostics. 6 (1): 2. doi:10.3390/diagnostics6010002. ISSN 2075-4418. PMC 4808817. PMID 26838799. (CC-BY 4.0)</ref>]]		[[File:Ultrasonography of acute pyelonephritis.jpg\|thumb\|[[Renal ultrasound]] showing acute pyelonephritis with increased cortical echogenicity and blurred delineation of the upper pole.<ref>Content initially copied from: Hansen, Kristoffer; Nielsen, Michael; Ewertsen, Caroline (2015). "Ultrasonography of the Kidney: A Pictorial Review". Diagnostics. 6 (1): 2. doi:10.3390/diagnostics6010002. ISSN 2075-4418. PMC 4808817. PMID 26838799. (CC-BY 4.0)</ref>]]
	[[File:PMC5428832 ijgm-10-137Fig1.png\|thumb\|CT without contrast showing bilateral perirenal fat stranding (~~open~~ arrow heads).]]		[[File:PMC5428832 ijgm-10-137Fig1.png\|thumb\|CT without contrast showing bilateral perirenal fat stranding (arrow heads).]]

	===Workup===		===Workup===

2022-04-20T21:53:06Z

Workup

← Older revision		Revision as of 21:53, 20 April 2022
Line 43:		Line 43:
	*[[Urine culture]]		*[[Urine culture]]
	*Consider imaging (CT or [[renal ultrasound\|ultrasound]]) if any of the following:		*Consider imaging (CT or [[renal ultrasound\|ultrasound]]) if any of the following:
			**''CT sensitivity 72%, specificity 58%''
	**History of [[Renal Stone]]		**History of [[Renal Stone]]
	**Poor response to [[antibiotics]]		**Poor response to [[antibiotics]]

2022-04-20T21:51:18Z

Evaluation

← Older revision		Revision as of 21:51, 20 April 2022
Line 37:		Line 37:
	[[File:Pyuria2011.jpg\|thumb\|Urine with pyuria.]]		[[File:Pyuria2011.jpg\|thumb\|Urine with pyuria.]]
	[[File:Ultrasonography of acute pyelonephritis.jpg\|thumb\|[[Renal ultrasound]] showing acute pyelonephritis with increased cortical echogenicity and blurred delineation of the upper pole.<ref>Content initially copied from: Hansen, Kristoffer; Nielsen, Michael; Ewertsen, Caroline (2015). "Ultrasonography of the Kidney: A Pictorial Review". Diagnostics. 6 (1): 2. doi:10.3390/diagnostics6010002. ISSN 2075-4418. PMC 4808817. PMID 26838799. (CC-BY 4.0)</ref>]]		[[File:Ultrasonography of acute pyelonephritis.jpg\|thumb\|[[Renal ultrasound]] showing acute pyelonephritis with increased cortical echogenicity and blurred delineation of the upper pole.<ref>Content initially copied from: Hansen, Kristoffer; Nielsen, Michael; Ewertsen, Caroline (2015). "Ultrasonography of the Kidney: A Pictorial Review". Diagnostics. 6 (1): 2. doi:10.3390/diagnostics6010002. ISSN 2075-4418. PMC 4808817. PMID 26838799. (CC-BY 4.0)</ref>]]
			[[File:PMC5428832 ijgm-10-137Fig1.png\|thumb\|CT without contrast showing bilateral perirenal fat stranding (open arrow heads).]]

	===Workup===		===Workup===

2020-05-02T10:42:25Z

Background

← Older revision		Revision as of 10:42, 2 May 2020
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	==Background==		==Background==
	[[File:Blausen 0592 KidneyAnatomy 01.png\|Renal anatomy.]]		[[File:Blausen 0592 KidneyAnatomy 01.png\|thumb\|Renal anatomy.]]
	===Definitions===		===Definitions===
	*UTI = significant bacteriuria in presence of symptoms		*UTI = significant bacteriuria in presence of symptoms

2020-05-02T10:42:11Z

Background

← Older revision		Revision as of 10:42, 2 May 2020
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	==Background==		==Background==
	[[File:~~KidneyStructures PioM~~.png~~\|thumb~~\|Renal structures: (1) renal pyramid; (2) interlobular artery; (3) renal artery; (4) renal vein; (5) renal hilum; (6) renal pelvis; (7) ureter; (8) minor calyx; (9) renal capsule; (10) inferior renal capsule; (11) superior renal capsule; (12) interlobular vein; (13) nephron; (14) renal sinus; (15) major calyx; (16) renal papilla; (17) renal column.]]		[[File:Blausen 0592 KidneyAnatomy 01.png\|Renal anatomy.]]
	===Definitions===		===Definitions===
	*UTI = significant bacteriuria in presence of symptoms		*UTI = significant bacteriuria in presence of symptoms

2020-05-02T10:39:31Z

Background

← Older revision		Revision as of 10:39, 2 May 2020
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	==Background==		==Background==
	[[File:KidneyStructures PioM.png\|thumb\|Renal structures: 1~~. Renal~~ pyramid • 2~~. Interlobular~~ artery • 3~~. Renal~~ artery • 4~~. Renal~~ vein 5~~. Renal~~ hilum • 6~~. Renal~~ pelvis • 7~~. Ureter •~~ 8~~. Minor~~ calyx • 9~~. Renal~~ capsule • 10~~. Inferior~~ renal capsule • 11~~. Superior~~ renal capsule • 12~~. Interlobular~~ vein • 13~~. Nephron •~~ 14~~. Renal~~ sinus • 15~~. Major~~ calyx • 16~~. Renal~~ papilla • 17. ~~Renal column~~]]		[[File:KidneyStructures PioM.png\|thumb\|Renal structures: (1) renal pyramid; (2) interlobular artery; (3) renal artery; (4) renal vein; (5) renal hilum; (6) renal pelvis; (7) ureter; (8) minor calyx; (9) renal capsule; (10) inferior renal capsule; (11) superior renal capsule; (12) interlobular vein; (13) nephron; (14) renal sinus; (15) major calyx; (16) renal papilla; (17) renal column.]]
	===Definitions===		===Definitions===
	*UTI = significant bacteriuria in presence of symptoms		*UTI = significant bacteriuria in presence of symptoms