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Pyonephrosis


Presentation

  • When fungus balls are present, they may obstruct the renal pelvis or the ureter, resulting in pyonephrosis.[emedicine.medscape.com]
Wound Infection
  • However, this was associated with a high morbidity and complication rate, including sepsis, wound infections, peritonitis, and fistulas.[emedicine.medscape.com]
Aspiration
  • In these cases, consider conducting an ultrasonographically guided aspiration of the hydronephrotic fluid for microscopic examination to establish the diagnosis.[emedicine.medscape.com]
Suggestibility
  • If echogenic gas is present, assume that the patient has a severe infection and possible renal injury suggestive of emphysematous pyelonephritis.[emedicine.medscape.com]
Irritability
  • […] cases and does not increase the risk of sepsis and bacteremia. [5] Disadvantages of retrograde decompression include lack of antegrade access for radiologic studies, a smaller-caliber urinary drainage catheter than with percutaneous access, increased irritative[emedicine.medscape.com]

Workup

  • Renal nuclear scanning Renal nuclear scanning is not particularly helpful in the immediate diagnostic workup of pyonephrosis.[emedicine.medscape.com]
Staphylococcus Aureus
  • Community-acquired methicillin-resistant Staphylococcus aureus as a cause of rapidly progressing pyelonephritis with pyonephrosis, necessitating emergent nephrectomy. Am J Med Sci. 2009 Sep. 338(3):233-5. [Medline].[emedicine.medscape.com]

Treatment

  • Treatment Controversies and Considerations Treatment of infections occurring from pyelonephritis [42] and pyonephrosis is changing rapidly and dramatically.[emedicine.medscape.com]

Prognosis

  • The prognosis of pyonephrosis is good in most patients who receive prompt diagnosis and treatment.[emedicine.medscape.com]

Etiology

  • Etiology Upper urinary tract infection in combination with obstruction and hydronephrosis may lead to pyonephrosis.[emedicine.medscape.com]

Epidemiology

  • Epidemiology Pyonephrosis is uncommon in adults and rare in children, and it is thought to be extremely rare in neonates.[emedicine.medscape.com]
Sex distribution
Age distribution

Prevention

  • The decreased function of the affected kidney that accompanies active infection typically prevents visualization on contrast studies.[emedicine.medscape.com]

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