Editing Urinary Tract Infections (section)

==== Acute focal and multifocal bacterial pyelonephritis ====
* '''Also known as lobar nephronia'''
* '''An uncommon, severe form of acute renal infection in which a heavy leukocyte infiltrate is confined to a single renal lobe (focal) or multiple lobes (multifocal).'''
* '''Represents a midpoint on the spectrum between pyelonephritis and renal abscess'''
* '''Clinical presentation is similar to that of patients with acute pyelonephritis but usually is more severe'''
* ≈50% of patients are diabetic, and sepsis is common
* '''The diagnosis must be made by radiologic examination (US or CT)'''
* '''Management'''
** '''Includes hydration and IV antimicrobial agents for at least 7 days, followed by 7 days of oral antimicrobial therapy'''
*** Failure to respond to antimicrobial therapy is an indication for appropriate studies to rule out obstructive uropathy, renal or perirenal abscess, renal carcinoma, or acute renal vein thrombosis