obsolete acute pyelonephritis without lesion of renal medullary necrosis

Based on the search results, I can provide information on the signs and symptoms of acute pyelonephritis.

Common Signs and Symptoms

• Sudden onset of fever and chills [2]
• Pain and/or tenderness with deep palpation in the flank or abdominal area [2]
• Fever and chills [5]
• Flank or abdominal pain [5]

These symptoms are commonly associated with acute pyelonephritis, but it's essential to note that not all patients may exhibit these signs.

Less Common Symptoms

• Nausea and vomiting (present in two-thirds of patients) [5]
• Dysuria (painful urination), which may not be present in some cases [5]

Keep in mind that the presence of renal medullary necrosis is a complication associated with acute pyelonephritis, but it's not explicitly mentioned as a symptom. The search results suggest that this condition can lead to more severe complications, such as kidney damage and failure.

References

• [2] Sudden onset of fever and chills.
• [5] Fever and chills, flank or abdominal pain, nausea and vomiting, dysuria may not be present.
• [5] Nausea and vomiting (present in two-thirds of patients).

Based on the search results, it appears that there are several diagnostic tests that can be used to diagnose acute pyelonephritis without lesion of renal medullary necrosis. Here are some of them:

• Urinalysis: This is a common initial test for diagnosing urinary tract infections (UTIs), including pyelonephritis. A urine sample is analyzed for the presence of bacteria, blood, and other substances that may indicate infection ([1], [11]).
• Ultrasound: An ultrasound scan can be used to assess the kidneys and urinary tract for signs of infection or damage. It can help identify complications such as kidney stones or blockages in the urinary tract ([12], [13]).
• Excretory urogram (EU): This is a type of imaging test that uses contrast dye to visualize the kidneys, ureters, and bladder. It can help diagnose pyelonephritis by showing signs of infection or damage in these areas ([12]).
• Magnetic Resonance Imaging (MRI): While not typically used as an initial diagnostic tool for acute pyelonephritis, MRI can be useful in detecting kidney infections or masses, and evaluating the kidney vasculature ([10]).

It's worth noting that while these tests can help diagnose acute pyelonephritis without lesion of renal medullary necrosis, a definitive diagnosis often requires laboratory testing and clinical evaluation. The specific diagnostic test used may depend on individual patient factors and the severity of symptoms.

References:

[1] Context result 3 [10] Context result 10 [11] Context result 11 [12] Context result 12

Treatment Options for Acute Pyelonephritis Without Medullary Necrosis

Acute pyelonephritis is a bacterial infection that can cause inflammation in the kidneys. In cases where there is no damage to the renal medulla, treatment typically involves antibiotics to target and eliminate the causative bacteria.

• Oral Antibiotics: For mild uncomplicated cases, outpatient oral antibiotic therapy with a fluoroquinolone (such as ciprofloxacin) or trimethoprim-sulfamethoxazole is often effective [2].
• Intravenous Treatment: In more severe cases or when patients cannot tolerate oral medication, intravenous treatment with a fluoroquinolone, an aminoglycoside (such as gentamicin), ampicillin, or a third-generation cephalosporin may be recommended [3]. The standard duration of therapy is typically 7-10 days.
• Adjusting Antibiotic Dosages: It's essential to adjust antibiotic dosages in patients with renal insufficiency to prevent further kidney damage [7].

Important Considerations

• Renal Function Monitoring: Regular monitoring of renal function is crucial during treatment to ensure that the kidneys are not being further compromised by the infection or antibiotics.
• Antibiotic Resistance: Be aware of potential antibiotic resistance patterns in your region, as this may impact treatment choices.

References:

[2] Outpatient oral antibiotic therapy with a fluoroquinolone is successful in most patients with mild uncomplicated pyelonephritis.

[3] Intravenous treatment is recommended with a fluoroquinolone, an aminoglycoside with or without ampicillin, or a third-generation cephalosporin.

[7] Adjust antibiotic dosages in patients with renal insufficiency.

Based on the search results, it appears that differential diagnosis for acute pyelonephritis without medullary necrosis is a clinical condition characterized by an acute onset of kidney injury. The principal differential diagnosis of this condition is its differentiation from Acute Tubular Necrosis (ATN).

According to [5], as a clinical condition characterized by an acute onset of kidney injury, the principal differential diagnosis of AIN (Acute Interstitial Nephritis) is its differentiation from ATN. This suggests that in cases where medullary necrosis is not present, the differential diagnosis for acute pyelonephritis would be more closely related to ATN.

Additionally, [7] mentions that diagnosis of Tubular Interstitial Nephritis (TIN) should be considered in any patient with unexplained renal failure and/or specific tubular dysfunction. This implies that TIN could also be a differential diagnosis for acute pyelonephritis without medullary necrosis.

Furthermore, [10] states that pyelonephritis must be differentiated from other causes of dysuria such as cystitis, urethritis, prostatitis, vulvovaginitis, urethral strictures or diverticula, benign prostatic hyperplasia, STDs and neoplasms such as renal cell carcinoma and from causes of abdominal pain such as ectopic pregnancy, renal stone, peritoneal or iliopsoas abscess. This suggests that a wide range of conditions could be considered in the differential diagnosis for acute pyelonephritis without medullary necrosis.

In summary, the differential diagnosis for obsolete acute pyelonephritis without lesion of renal medullary necrosis would include:

• Acute Tubular Necrosis (ATN)
• Tubular Interstitial Nephritis (TIN)
• Other causes of dysuria and abdominal pain such as cystitis, urethritis, prostatitis, vulvovaginitis, urethral strictures or diverticula, benign prostatic hyperplasia, STDs and neoplasms such as renal cell carcinoma.

References:

[5] by R Raghavan · 2014 · Cited by 194 — As a clinical condition characterized by an acute onset of kidney injury, the principal differential diagnosis of AIN is its differentiation from ATN. [7] by A Rastegar · 1998 · Cited by 94 — Diagnosis of TIN should be considered in any patient with unexplained renal failure and/or specific tubular dysfunction. [10] Pyelonephritis must be differentiated from other causes of dysuria such as cystitis, urethritis, prostatitis, vulvovaginitis, urethral strictures or diverticula, benign prostatic hyperplasia, STDs and neoplasms such as renal cell carcinoma and from causes of abdominal pain such as ectopic pregnancy, renal stone, peritoneal or iliopsoas abscess.