Bacterial renal infection: role of CT.

Abstract

The imaging studies done on 62 patients hospitalized for acute renal infections were retrospectively reviewed. Thirty-six (58%) had one or more abscesses, 17 (27%) had focal or diffuse acute bacterial nephritis, five (8%) had pyonephrosis, and four (6%) had pyelonephritis. All had prolonged fever (greater than or equal to 72 hours) and leukocytosis. Among 25 patients examined with both ultrasound (US) and computed tomography (CT), US failed to depict three of five (60%) cases of acute bacterial nephritis and seven of 15 (47%) intrarenal and extrarenal abscesses. One renal abscess was misdiagnosed as a tumor at CT. US is not an adequate screening test for detecting lesions that may require invasive therapy. CT is more sensitive for the detection of acute renal inflammatory disease and for defining the extent of disease for planning of radiologic or surgical intervention.

Comparative Evaluation of Ultrasonography and Computed Tomography Findings in Renal Masses.

“…Our study is also consistent with study of Soulen et al [28] (1989)which concluded that USG was not an adequate screening test for detecting lesions that may require invasive therapy. CT was more sensitive for the detection of acute renal inflammatory disease and for defining the extent of disease for planning of radiologic or surgical intervention.…”

Studies on Clinical Characteristics, Urovirulence Factor and Host Susceptibility Gene in Pediatric Acute Lobar Nephronia

“…Although renal ultrasonography (US) has been considered as the best and most-effective screening method, various false positive and false negative findings have been reported previously (Rosenfield et al, 1979;Soulen et al, 1989). Computed tomography (CT), instead, has been currently recognized as the most-sensitive and -specific imaging modality for diagnosing ALN (Kline et al, 1988;Soulen et al, 1989;Rathore et al, 1991;Klar et al, 1996;Uehling et al, 2000).…”

“…The clinical severity of acute renal bacterial infection spans continuously from an uncomplicated lower urinary tract infection (i.e. cystitis) to frank abscess formation (Soulen et al, 1989). Among these UTIs, renal parenchymal infections, including uncomplicated acute pyelonephritis (APN), acute lobar nephronia (ALN), and intrarenal abscess, are considered to be more serious forms of UTI.…”

“…Acute lobar nephronia (ALN), also known as acute focal bacterial nephritis, is an acute localized bacterial renal infection presenting as an inflammatory mass without liquefaction (Rosenfield et al, 1979;Zaontz et al, 1985;Kline et al, 1988;Klar et al, 1996, Uehling et al, 2000. The typical clinical presentations include fever, flank pain, leukocytosis, pyuria and bacteriuria, similar to presentations of patients with renal abscess or acute pyelonephritis (Zaontz et al, 1985;Soulen et al, 1989). It has previously been indicated as a complicated form of acute renal infection, representing the progression of the inflammatory process of APN (Nosher et al, 1988).…”

Diagnosis and localization of a complicated urinary tract infection in neurogenic bladder disease by tubular proteinuria and serum prostate specific antigen

“…CT scan and isotopic scans are considered the gold standards. 4,5 The bladder wash-out test can di erentiate between high and low UTI but it has never been accepted as the gold standard. This test can be false positive in prostatitis, 7 which itself is di cult to diagnose.…”