What is the ultrasound appearance of pyelonephritis?

In most patients with acute pyelonephritis, the kidney appears normal on US. On gray-scale sonography, there may be diffuse or focal enlargement of the kidney, sometimes with a mass-like appearance. The involved areas are usually hyperechoic (Figs. 3A, C) and may be wedge shaped or round.

What is the pathophysiology of pyelonephritis?

Acute pyelonephritis results from bacterial invasion of the renal parenchyma. Bacteria usually reach the kidney by ascending from the lower urinary tract. In all age groups, episodes of bacteriuria occur commonly, but most are asymptomatic and do not lead to infection.

What type of imaging is used for pyelonephritis?

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.

How does pyelonephritis show on CT scan?

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).

What are the complications of pyelonephritis?

Acute pyelonephritis can have several complications such as renal or perinephric abscess formation, sepsis, renal vein thrombosis, papillary necrosis, or acute renal failure, with one of the more serious complications being emphysematous pyelonephritis.

What is the difference between hydronephrosis and pyelonephritis?

The most common complication of hydronephrosis is the development of a urinary tract infection (UTI). 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.

What are the main causes of pyelonephritis?

The main cause of acute pyelonephritis is gram-negative bacteria, the most common being Escherichia coli. Other gram-negative bacteria which cause acute pyelonephritis include Proteus, Klebsiella, and Enterobacter.

What is the best antibiotic for pyelonephritis?

Outpatient oral antibiotic therapy with a fluoroquinolone is successful in most patients with mild uncomplicated pyelonephritis. Other effective alternatives include extended-spectrum penicillins, amoxicillin-clavulanate potassium, cephalosporins, and trimethoprim-sulfamethoxazole.

How is pyelonephritis diagnosed?

Urinalysis and urine culture confirm the diagnosis of acute pyelonephritis. The consensus definition of pyelonephritis established by the Infectious Diseases Society of America (IDSA) is a urine culture showing at least 10,000 colony-forming units (CFU) per mm3 and symptoms compatible with the diagnosis.

What is the difference between Pyonephrosis and pyelonephritis?

Pyonephrosis is characterized by accumulation of purulent debris and sediment in the renal pelvis and urinary collecting system. Children with pyonephrosis have symptoms similar to those of acute pyelonephritis, but frequently symptoms are more severe or persistent, or there are additional signs of hydronephrosis.

Can you see pyelonephritis on CT scan without contrast?

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

What is the difference between pyelitis and pyelonephritis?

A similar term is “pyelitis”, which means inflammation of the renal pelvis and calyces. In other words, pyelitis together with nephritis is collectively known as pyelonephritis.

Can a ultrasound be used to detect acute pyelonephritis?

Ultrasound, however, can easily detect the presence of obstruction as well as demonstrate characteristic findings suggestive of acute pyelonephritis, and thus allows differentiation. In t … Acute pyelonephritis and acute ureteral obstruction often present with similar clinical and urographic findings.

What are the sonographic features of pyelonephritis in dogs?

Sonographic features of canine and feline pyelonephritis are sparingly described in the literature. Penninck and d’Anjou (Atlas of Small Animal Ultrasonography, 2nd Edition) list only diffuse hyperechogenicity, pyelectasia, distorted diverticulae and renal pelvis with hyperechoic rim as potential features.

What kind of infection is acute pyelonephritis?

Acute pyelonephritis is a bacterial infection of the renal pelvis and parenchyma most commonly seen in young women.

Are there any cases of pyelonephritis in cats?

The renal capsule is thickened and irregular. And a third case; also a cat, with a rather dramatic emphysematous pyelonephritis (hyperechoic gas bubbles): If the literature is light on the sonographic diagnosis of pyelonephritis, it’s positively deficient in evidence as to best treatment.