pyonephrosis

Clinical symptoms in patients with pyonephrosis can range from frank sepsis (15%) to asymptomatic bacteriuria. Upon physical examination, the hydronephrotic kidney may be linked to a palpable abdominal mass. On rare occasions, the hydronephrotic kidney infection may burst spontaneously into the peritoneal cavity, resulting in diffuse peritonitis and sepsis in certain patients.{{cite journal | last1=Quaresima | first1=Silvia | last2=Manzelli | first2=Antonio | last3=Ricciardi | first3=Edoardo | last4=Petrou | first4=Athanasios | last5=Brennan | first5=Nicholas | last6=Mauriello | first6=Alessandro | last7=Rossi | first7=Piero | title=Spontaneous intraperitoneal rupture of pyonephrosis in a patient with unknown kidney carcinosarcoma: a case report | journal=World Journal of Surgical Oncology | publisher=BMC | volume=9 | date=2011 | pmid=21486444 | doi=10.1186/1477-7819-9-39 | page=39| doi-access=free | pmc=3087700 }}

Pyonephrosis can result from an upper urinary tract infection combined with blockage and hydronephrosis.{{cite journal | last=Peterson | first=Andrew C | title=Pyonephrosis: Practice Essentials, Etiology, Prognosis | website=emedicine.medscape.com | date=December 14, 2023 |url=https://emedicine.medscape.com/article/440548-overview#a2 | access-date=December 28, 2023}}

When a patient has suspected pyonephrosis, the initial workup should consist of a complete blood count, serum chemistry with blood urea nitrogen (BUN) and creatinine, blood cultures, and urinalysis with culture{{cite journal | last1=M | first1=St Lezin | last2=R | first2=Hofmann | last3=ML | first3=Stoller | title=Pyonephrosis: diagnosis and treatment | journal=British Journal of Urology | date=1992 | publisher=Br J Urol | volume=70 | issue=4 | pages=360–363 | issn=0007-1331 | pmid=1450841 | doi=10.1111/j.1464-410x.1992.tb15788.x |url=https://pubmed.ncbi.nlm.nih.gov/1450841/ | access-date=December 28, 2023 }}

It is generally not recommended to perform routine radiographic imaging on patients who have simple urinary tract infections. When patients do not improve quickly with appropriate antibiotics, however, appropriate radiographic studies help diagnose pyonephrosis, emphysematous pyelonephritis, and renal and/or perirenal abscesses.{{cite journal | last1=DA | first1=Baumgarten | last2=BR | first2=Baumgartner | title=Imaging and radiologic management of upper urinary tract infections | journal=The Urologic Clinics of North America | date=1997 | publisher=Urol Clin North Am | volume=24 | issue=3 | pages=545–569 | issn=0094-0143 | pmid=9275978 | doi=10.1016/s0094-0143(05)70401-8 |url=https://pubmed.ncbi.nlm.nih.gov/9275978/ | access-date=December 28, 2023 }}

Together with intravenous antibiotics, drainage{{cite journal | last1=S | first1=Ramsey | last2=A | first2=Robertson | last3=MJ | first3=Ablett | last4=RN | first4=Meddings | last5=GW | first5=Hollins | last6=B | first6=Little | title=Evidence-based drainage of infected hydronephrosis secondary to ureteric calculi | journal=Journal of Endourology | date=2010 | publisher=J Endourol | volume=24 | issue=2 | pages=185–189 | issn=1557-900X | pmid=20063999 | doi=10.1089/end.2009.0361 |url=https://pubmed.ncbi.nlm.nih.gov/20063999/ | access-date=December 28, 2023 }}—either percutaneous or retrograde with a ureteral stent{{cite journal | last1=ZL | first1=Barbaric | last2=T | first2=Hall | last3=ST | first3=Cochran | last4=DR | first4=Heitz | last5=RA | first5=Schwartz | last6=RM | first6=Krasny | last7=MW | first7=Deseran | title=Percutaneous nephrostomy: placement under CT and fluoroscopy guidance | journal=AJR. American Journal of Roentgenology | date=1997 | publisher=AJR Am J Roentgenol | volume=169 | issue=1 | pages=151–155 | issn=0361-803X | pmid=9207516 | doi=10.2214/ajr.169.1.9207516 |url=https://pubmed.ncbi.nlm.nih.gov/9207516/ | access-date=December 28, 2023 }}—has become the cornerstone of treatment since the development of ultrasonography and computed tomography (CT) scanning. Drainage offers a great outcome with low rates of morbidity and mortality. A CT scan or ultrasound-guided drainage greatly reduces the need for a nephrectomy.

• Pyelonephritis
• Nephrotic syndrome

{{Reflist}}

• {{cite book | last1=Pappas | first1=Diane E. | last2=Hendley | first2=J. Owen | last3=Meissner | first3=H. Cody | last4=Nayak | first4=Jennifer Lynn | last5=Caserta | first5=Mary T. | last6=Arvin | first6=Ann M. | last7=Ross | first7=Shannon A. | last8=Kimberlin | first8=David W. | last9=Prober | first9=Charles G. | title=Principles and Practice of Pediatric Infectious Diseases | chapter=Urinary Tract Infections, Renal Abscess, and Other Complex Renal Infections | publisher=Elsevier | date=January 1, 2023 | pages=352–358.e4 | doi=10.1016/B978-0-323-75608-2.00048-3 | isbn=9780323756082 |chapter-url=https://www.sciencedirect.com/science/article/abs/pii/B9780323756082000483 | access-date=December 28, 2023 | ref=none}}
• {{cite book | last1=Yu | first1=Mei-Hong | last2=Tu | first2=Yue-Xing | last3=Wityk | first3=Paweł | last4=Rak | first4=Janusz | last5=Fandilolu | first5=Prayagraj M. | last6=Sonawane | first6=Kailas D. | last7=Zhang | first7=Zao | last8=Hayashi | first8=Rick | last9=Mostofi | first9=Keyvan | last10=Daryabin | first10=Mathieu | last11=Kuljanin | first11=Miljan | last12=Lajoie | first12=Gilles A. | title=Principles and Practice of Pediatric Infectious Diseases | chapter=Renal Abscess and Other Complex Renal Infections | publisher=Elsevier | date=January 1, 2012 | pages=343–345.e1 | doi=10.1016/B978-1-4377-2702-9.00050-7 | isbn=9781437727029 |chapter-url=https://www.sciencedirect.com/science/article/abs/pii/B9781437727029000507 | access-date=December 28, 2023 | ref=none}}

{{Medical resources

| ICD11 = {{ICD11|GB58}}

| ICD10 = {{ICD10|N13.6}}

| ICD10CM =

| ICD9 = {{ICD9|590.80}}

| ICDO =

| OMIM =

| MeshID = D053018

| DiseasesDB =

| SNOMED CT = 48631008

| Curlie =

| MedlinePlus =

| eMedicineSubj = med

| eMedicineTopic = 2851

| PatientUK =

| NCI =

| GeneReviewsNBK =

| GeneReviewsName =

| NORD =

| GARDNum =

| GARDName =

| RP = 19322

| AO =

| WO =

| OrthoInfo =

| Orphanet =

| Scholia = Q1047294

| OB =

}}

{{Nephrology}}

Category:Medical terminology

Category:Kidney diseases