Which infection is associated with Xanthogranulomatous pyelonephritis?

Xanthogranulomatous pyelonephritis (XGP), first described by Schlagenhaufer in 1916, is a rare, serious, chronic inflammatory disorder of the kidney characterized by a destructive mass that invades the renal parenchyma. XGP is most commonly associated with Proteus or Escherichia coli infection.

What is the definitive management for Xanthogranulomatous pyelonephritis?

Xanthogranulomatous pyelonephritis (XGP) is a surgically managed disease that is treated with either nephrectomy or, in rare circumstances, partial nephrectomy. Antibiotics are used in all cases, but medical care rarely suffices for treatment.

How is Pyonephrosis diagnosed?

The diagnosis of pyonephrosis is suspected when the clinical symptoms of fever and flank pain are combined with the radiologic evidence of obstruction to the urinary tract. Sonography gives a prompt diagnosis of hydronephrosis, and needle puncture of the kidney yields pus and establishes the presence of pyonephrosis.

What causes Xanthogranulomatous pyelonephritis?

Xanthogranulomatous pyelonephritis is a chronic inflammatory condition that is caused by pyogenic infection of the kidney, usually secondary to staghorn calculi (70% of cases), most commonly by Proteus or E. coli.

What is Xanthogranulomatous inflammation?

Xanthogranulomatous inflammation (XGI) is a rare benign inflammatory disease characterized by aggregation of lipid-laden foamy macrophages. This disease entity has been described in various organs but most commonly in the kidney and gallbladder.

What clinical finding suggests a diagnosis of nephritic syndrome?

The classic symptoms of the nephritic syndrome are: Hypertension or poorly controlled blood pressure (BP) in patients with previously controlled BP. Renal insufficiency characterized by oliguria (reduced urine output), and azotemia, due to decreased glomerular filtration rate (GFR)

What is the difference between Pyonephrosis and pyelonephritis?

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 the difference between hydronephrosis and pyelonephritis?

When the UTI is associated with a high fever, a kidney infection is (pyelonephritis) is suspected. This is caused by bacteria spreading from the bladder to the kidney and invading the kidney tissue. Children with severe hydronephrosis (moderate-severe, grade 3 and 4) have a higher risk of UTI/pyelonephritis.

Can pyelonephritis cause pleural effusion?

Conclusion: Though quite rare, pleural effusion is a potential complication of acute pyelonephritis. The exact pathogenesis of transudative pleural effusion is unknown, but the effusion may resolve spontaneously when infection is adequately controlled.

What causes Xanthogranulomatous?

Xanthogranulomatous (XG) processes are rare aggressive inflammatory conditions that can be caused by infection, inflammation, histiocytic processes, or inherited lysosomal disorders [1, 2] (Fig.

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 significant signs of nephritic syndrome?

Common symptoms of nephritic syndrome are:

• Blood in the urine (urine appears dark, tea-colored, or cloudy)
• Decreased urine output (little or no urine may be produced)
• Swelling of the face, eye socket, legs, arms, hands, feet, abdomen, or other areas.
• High blood pressure.

What is difference between nephrotic and nephritic syndrome?

Nephrotic syndrome is characterized by severe proteinuria, i.e. high amounts of protein, including albumin, in the urine, while nephritic syndrome’s major feature is inflammation. Depending on the specific underlying conditions of the two, nephrotic syndrome often is the more serious.

How does pyelonephritis appear on CT?

It appears along with dilated renal calyces in a contrast CT and with an appearance colloquially described as the “bear paw sign” in large calculi (Figure 5) and xanthogranulomatous pyelonephritis with staghorn calculi.

What does pyelonephritis look like on CT?

The type of emphysematous pyelonephritis can be easily and accurately defined on the basis of CT findings (,31). Findings include parenchymal enlargement and destruction, small bubbly or linear streaks of gas, fluid collections, gas-fluid levels, and focal tissue necrosis with or without abscess (,31,,32).

Can a UTI cause pleural effusion?

The most common causes of transudative pleural effusions are congestive heart failure, liver cirrhosis with ascites, and nephrotic syndrome [1] . A variety of intra-abdominal or pelvic dis- orders, such as renal and/or perirenal abscesses [2] and urinary tract obstruction [3–7] are associated with pleural effusion.

Can urinary retention cause pleural effusion?

Urinothorax refers to the presence of urine in the pleural space secondary to obstructive uropathy, and is an unusual cause of pleural effusion. The importance of recognising this entity lies in the fact that the condition is completely reversible following relief of urinary tract obstruction.

What is Xanthogranulomatous?

Xanthogranulomatous pyelonephritis is a rare and aggressive variant of chronic pyelonephritis. It usually occurs due to chronic nephrolithiasis and infection. The diagnosis is often confused with renal cell carcinoma, and a computed tomography (CT) scan, as well as histology of the mass, helps to confirm the diagnosis.

Why does GFR fall in nephritic syndrome?

Plasma creatinine levels can estimate GFR to determine the stage of chronic kidney disease. [21] In nephritic syndrome, the excretion of urea and creatinine is impaired due to the disruption of GFB. This results in azotemia, elevated creatine level, and reduced GFR.

What is a hallmark of the diagnosis of nephrotic syndrome?

The hallmark of idiopathic nephrotic syndrome (INS) is massive proteinuria, leading to decreased circulating albumin levels.

What are the three distinct symptoms of nephrotic syndrome?

Signs and symptoms of nephrotic syndrome include:

• Severe swelling (edema), particularly around your eyes and in your ankles and feet.
• Foamy urine, a result of excess protein in your urine.
• Weight gain due to fluid retention.
• Fatigue.
• Loss of appetite.

Can you see pyelonephritis on non contrast CT?

Pyelonephritis is the most common alternative genitourinary diagnosis in patients imaged with a non-contrast CT for suspected renal calculi.

Will a kidney infection show up on a CT scan?

A health care professional may use imaging tests, such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or ultrasound, to help diagnose a kidney infection.

Does pyelonephritis show on CT?

CT is the modality of choice for evaluating patients with emphysematous pyelonephritis. The type of emphysematous pyelonephritis can be easily and accurately defined on the basis of CT findings (,31).

Can you diagnose pyelonephritis on CT?

Computed tomography (CT) of the abdomen and pelvis with contrast is considered the study of choice in complicated acute pyelonephritis. CT can detect focal parenchymal abnormalities, emphysematous changes, and anatomic anomalies, and can also define the extent of disease.