Presentation
When fungus balls are present, they may obstruct the renal pelvis or the ureter, resulting in pyonephrosis. [emedicine.medscape.com]
Cas Clinique Published: 17 September 2010 Squamous cell carcinoma of the pelvis presenting as pyonephrosis. A case report and review of the literature M. Dakir1, H. Balhouss1, M. Elbaghouli, M. Karkouri2, S. Belhaj2, S. Zamiati, H. Fekak1, R. [link.springer.com]
Workup
Renal nuclear scanning Renal nuclear scanning is not particularly helpful in the immediate diagnostic workup of pyonephrosis. [emedicine.medscape.com]
X-Ray
- Pneumoperitoneum
Other rare complications include pneumoperitoneum from lithogenic pyonephrosis, nephrobronchial fistula, renal vein thrombosis, psoas abscess and/or perinephric abscess, and rhabdomyolysis. [emedicine.medscape.com]
Urine
- Pyuria
Pyuria, while often present in pyonephrosis, is nonspecific. Bacteruria, fever, pain, and leukocytosis can be absent in 30% of patients with pyonephrosis. C-reactive protein (CRP) value has been shown to help in the diagnosis of pyonephrosis. [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]
Squamous cell carcinoma of the renal pelvis and ureter: Incidence, symptoms, treatment and outcome. J.Urol. 2007; Jul;178(1):51–56. [link.springer.com]
Prognosis
Abstract Squamous cell carcinoma of the renal pelvis is a rare tumor with a poor prognosis, mainly occurring in patients with neglected and secondarily infected pyelocalyceal stones. [link.springer.com]
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]
Prevention
The decreased function of the affected kidney that accompanies active infection typically prevents visualization on contrast studies. [emedicine.medscape.com]