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The clinical and imaging presentation of acute "non complicated" pyelonephritis: A new profile for an ancient disease

BACKGROUND: Acute pyelonephritis (APN) is differently defined according to imaging or clinical criteria. In adults information on the relationship between imaging and clinical data is lacking. Our study was aimed at analysing the relationship between the clinical and imaging presentation of APN, def...

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Autores principales: Piccoli, Giorgina Barbara, Consiglio, Valentina, Deagostini, Maria Chiara, Serra, Melania, Biolcati, Marilisa, Ragni, Francesca, Biglino, Alberto, De Pascale, Agostino, Frascisco, Mauro Felice, Veltri, Andrea, Porpiglia, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268718/
https://www.ncbi.nlm.nih.gov/pubmed/22171968
http://dx.doi.org/10.1186/1471-2369-12-68
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author Piccoli, Giorgina Barbara
Consiglio, Valentina
Deagostini, Maria Chiara
Serra, Melania
Biolcati, Marilisa
Ragni, Francesca
Biglino, Alberto
De Pascale, Agostino
Frascisco, Mauro Felice
Veltri, Andrea
Porpiglia, Francesco
author_facet Piccoli, Giorgina Barbara
Consiglio, Valentina
Deagostini, Maria Chiara
Serra, Melania
Biolcati, Marilisa
Ragni, Francesca
Biglino, Alberto
De Pascale, Agostino
Frascisco, Mauro Felice
Veltri, Andrea
Porpiglia, Francesco
author_sort Piccoli, Giorgina Barbara
collection PubMed
description BACKGROUND: Acute pyelonephritis (APN) is differently defined according to imaging or clinical criteria. In adults information on the relationship between imaging and clinical data is lacking. Our study was aimed at analysing the relationship between the clinical and imaging presentation of APN, defined according to imaging criteria (parenchymal involvement at MR or CT scan). METHODS: All consecutive patients hospitalized for "non-complicated" APN were considered (June 2005-December 2009). Clinical, biochemical and imaging data at hospitalization were analyzed by univariate and logistic regression analysis. RESULTS: There were 119 patients, all females, median age 32 years (15-72). At hospitalization, inflammatory markers were elevated (CRP median: 12.1 mg/dL, normal < 0.8). Incomplete presentations were frequent: fever was absent in 6.7%, pain in 17.8%, lower urinary tract symptoms in 52.9%. At CT or MR scan the lesions were bilateral in 12.6%, multiple in 79.8%; abscesses were present in 39.5%. Renal scars were found in 15.1%. Positive cultures were correlated with multiple foci (multivariate OR 4.2; CI 1.139-15.515). No other sign/symptom discriminated between small lesions, abscesses or multifocal involvement. CONCLUSIONS: APN is a protean disease. In the absence of strict correlation with clinical or biochemical markers, imaging studies are required to assess the severity of kidney involvement.
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spelling pubmed-32687182012-01-31 The clinical and imaging presentation of acute "non complicated" pyelonephritis: A new profile for an ancient disease Piccoli, Giorgina Barbara Consiglio, Valentina Deagostini, Maria Chiara Serra, Melania Biolcati, Marilisa Ragni, Francesca Biglino, Alberto De Pascale, Agostino Frascisco, Mauro Felice Veltri, Andrea Porpiglia, Francesco BMC Nephrol Research Article BACKGROUND: Acute pyelonephritis (APN) is differently defined according to imaging or clinical criteria. In adults information on the relationship between imaging and clinical data is lacking. Our study was aimed at analysing the relationship between the clinical and imaging presentation of APN, defined according to imaging criteria (parenchymal involvement at MR or CT scan). METHODS: All consecutive patients hospitalized for "non-complicated" APN were considered (June 2005-December 2009). Clinical, biochemical and imaging data at hospitalization were analyzed by univariate and logistic regression analysis. RESULTS: There were 119 patients, all females, median age 32 years (15-72). At hospitalization, inflammatory markers were elevated (CRP median: 12.1 mg/dL, normal < 0.8). Incomplete presentations were frequent: fever was absent in 6.7%, pain in 17.8%, lower urinary tract symptoms in 52.9%. At CT or MR scan the lesions were bilateral in 12.6%, multiple in 79.8%; abscesses were present in 39.5%. Renal scars were found in 15.1%. Positive cultures were correlated with multiple foci (multivariate OR 4.2; CI 1.139-15.515). No other sign/symptom discriminated between small lesions, abscesses or multifocal involvement. CONCLUSIONS: APN is a protean disease. In the absence of strict correlation with clinical or biochemical markers, imaging studies are required to assess the severity of kidney involvement. BioMed Central 2011-12-15 /pmc/articles/PMC3268718/ /pubmed/22171968 http://dx.doi.org/10.1186/1471-2369-12-68 Text en Copyright ©2011 Piccoli et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Piccoli, Giorgina Barbara
Consiglio, Valentina
Deagostini, Maria Chiara
Serra, Melania
Biolcati, Marilisa
Ragni, Francesca
Biglino, Alberto
De Pascale, Agostino
Frascisco, Mauro Felice
Veltri, Andrea
Porpiglia, Francesco
The clinical and imaging presentation of acute "non complicated" pyelonephritis: A new profile for an ancient disease
title The clinical and imaging presentation of acute "non complicated" pyelonephritis: A new profile for an ancient disease
title_full The clinical and imaging presentation of acute "non complicated" pyelonephritis: A new profile for an ancient disease
title_fullStr The clinical and imaging presentation of acute "non complicated" pyelonephritis: A new profile for an ancient disease
title_full_unstemmed The clinical and imaging presentation of acute "non complicated" pyelonephritis: A new profile for an ancient disease
title_short The clinical and imaging presentation of acute "non complicated" pyelonephritis: A new profile for an ancient disease
title_sort clinical and imaging presentation of acute "non complicated" pyelonephritis: a new profile for an ancient disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268718/
https://www.ncbi.nlm.nih.gov/pubmed/22171968
http://dx.doi.org/10.1186/1471-2369-12-68
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