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Pyonephrosis

Infection and accumulation of pus within the kidney

Field	Value
name	Pyonephrosis
image	Kidney showing a condition of acute pyonephrosis Wellcome L0061752.jpg
caption	Watercolour drawing of a dissected kidney, showing a condition of acute pyonephrosis. The ureter is blocked by a calculus and several calculi are seen lying in the sacculi.

Pyonephrosis () is a dangerous kidney infection that is characterized by pus accumulation in the renal collecting system. It is linked to renal collecting system blockage and suppurative renal parenchymal destruction, which result in complete or nearly complete kidney failure.

Signs and symptoms

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.

Cause

Pyonephrosis can result from an upper urinary tract infection combined with blockage and hydronephrosis.

Diagnosis

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

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.

Treatment

Together with intravenous antibiotics, drainage—either percutaneous or retrograde with a ureteral stent—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.

References

{{DorlandsDict. seven/000088935. pyonephrosis
(July 1, 2016). "Pyonephrosis among Patients with Pyelonephritis Admitted in Department of Nephrology and Urology of a Tertiary Care Centre: A Descriptive Cross-sectional Study". Nepal Medical Association.
(2015). "Pyonephrosis: diagnosis and treatment: report of 65 cases". Jurnal Medical Brasovean.
(2011). "Spontaneous intraperitoneal rupture of pyonephrosis in a patient with unknown kidney carcinosarcoma: a case report". BMC.
Peterson, Andrew C. (December 14, 2023). "Pyonephrosis: Practice Essentials, Etiology, Prognosis".
(1992). "Pyonephrosis: diagnosis and treatment". Br J Urol.
(1997). "Imaging and radiologic management of upper urinary tract infections". Urol Clin North Am.
(2010). "Evidence-based drainage of infected hydronephrosis secondary to ureteric calculi". J Endourol.
(1997). "Percutaneous nephrostomy: placement under CT and fluoroscopy guidance". AJR Am J Roentgenol.

Info: Wikipedia Source

This article was imported from Wikipedia and is available under the Creative Commons Attribution-ShareAlike 4.0 License. Content has been adapted to SurfDoc format. Original contributors can be found on the article history page.

medical-terminology kidney-diseases

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