Urinary Tract Infections: Difference between revisions

Line 973:

=== Infectious Granulomatous Nephritis ===

==== Xanthogranulomatous pyelonephritis (XGP) ====

==== Xanthogranulomatous pyelonephritis (XGP)[https://www.ncbi.nlm.nih.gov/books/NBK557399/] ====

*Epidemiology

**Rare

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**'''Severe, chronic renal infection typically resulting in diffuse renal destruction'''

**'''Begins within the pelvis and calyces and subsequently extends into and destroys renal parenchymal and adjacent tissues'''

**'''~~Primary factors involved in the pathogenesis~~ of XGP (3):'''

**'''Pathogenesis of XGP (3):'''

**'''Nephrolithiasis (usually staghorn)'''

**#'''Nephrolithiasis (usually staghorn) leading to'''

**'''~~Obstruction~~'''

**#'''Chronic obstruction and'''

**'''Infection'''

**#'''Infection'''

**'''Pathogens'''

**'''Proteus is the most common organism involved with XGP'''

***'''Proteus is the most common organism involved with XGP'''

**'''E. coli is also common'''

***'''E. coli is also common'''

**'''Diagnosis and Evaluation'''

** '''Most cases are unilateral and result in a non-functioning, enlarged kidney associated with obstructive uropathy secondary to nephrolithiasis.'''

*** '''Most cases are unilateral and result in a non-functioning, enlarged kidney associated with obstructive uropathy secondary to nephrolithiasis.'''

** The infecting organism may be revealed only by tissue cultures obtained during surgery.

*** The infecting organism may be revealed only by tissue cultures obtained during surgery.

*** ≈10% of patients have mixed cultures.

**** ≈10% of patients have mixed cultures.

*** ≈1/3rd of patients have no growth in their urine, probably because many patients have recently taken or are taking antibiotics when cultures are obtained.

**** ≈1/3rd of patients have no growth in their urine, probably because many patients have recently taken or are taking antibiotics when cultures are obtained.

** Urinalysis usually shows pus and protein

*** Urinalysis usually shows pus and protein

** '''Imaging'''

*** '''CT'''

@@ Line 973: / Line 973: @@
 === Infectious Granulomatous Nephritis ===
-==== Xanthogranulomatous pyelonephritis (XGP) ====
+==== Xanthogranulomatous pyelonephritis (XGP)[https://www.ncbi.nlm.nih.gov/books/NBK557399/] ====
 *Epidemiology
 **Rare
@@ Line 981: / Line 981: @@
 **'''Severe, chronic renal infection typically resulting in diffuse renal destruction'''
 **'''Begins within the pelvis and calyces and subsequently extends into and destroys renal parenchymal and adjacent tissues'''
-**'''Primary factors involved in the pathogenesis of XGP (3):'''
+**'''Pathogenesis of XGP (3):'''
-**'''Nephrolithiasis (usually staghorn)'''
+**#'''Nephrolithiasis (usually staghorn) leading to'''
-**'''Obstruction'''
+**#'''Chronic obstruction and'''
-**'''Infection'''
+**#'''Infection'''
 **'''Pathogens'''
-**'''Proteus is the most common organism involved with XGP'''
+***'''Proteus is the most common organism involved with XGP'''
-**'''E. coli is also common'''
+***'''E. coli is also common'''
 **'''Diagnosis and Evaluation'''
-** '''Most cases are unilateral and result in a non-functioning, enlarged kidney associated with obstructive uropathy secondary to nephrolithiasis.'''
+*** '''Most cases are unilateral and result in a non-functioning, enlarged kidney associated with obstructive uropathy secondary to nephrolithiasis.'''
-** The infecting organism may be revealed only by tissue cultures obtained during surgery.
+*** The infecting organism may be revealed only by tissue cultures obtained during surgery.
-*** ≈10% of patients have mixed cultures.
+**** ≈10% of patients have mixed cultures.
-*** ≈1/3rd of patients have no growth in their urine, probably because many patients have recently taken or are taking antibiotics when cultures are obtained.
+**** ≈1/3rd of patients have no growth in their urine, probably because many patients have recently taken or are taking antibiotics when cultures are obtained.
-** Urinalysis usually shows pus and protein
+*** Urinalysis usually shows pus and protein
 ** '''Imaging'''
 *** '''CT'''