Acute Pyelonephritis - Correlation of Clinical Parameter with Radiological Imaging Abnormalities TC15-TC18
Dr. Leelavathi Venkatesh,
Door No. 39, 1st Cross, Nagappa Block, M.K.K. Road, Srirampuram Post, Bengaluru-560021, Karnataka, India.
Introduction: Pyelonephritis (PN) is a suppurative infection of the kidney, most commonly due to bacterial infection and may be either acute or chronic. Acute PN (APN) subdivided into uncomplicated and complicated. Severity of PN cannot be assessed by clinical or laboratorial parameters alone, radiological imaging such as Ultrasound (USG) abdomen, Computed Tomography (CT) is required to know the nature, extent and severity of disease and for planning interventions.
Aim: The aim of this study was to compare clinical and biochemical parameters with radiological findings (USG/CT) among patients diagnosed to have PN.
Materials and Methods: The medical records of all patients admitted with PN at the Institute of Nephrourology, Bangalore from January 2016 to December 2016 were reviewed.Their clinical and biochemical parameter were compared with radiological findings.Statistical analysis was performed with Statistical Package for the Social Sciences (SPSS) Version 15.0.
Results: There were 100 patients diagnosed with PN in the study period. Mean age of patient was 48.7 years and PN was common among females (62%). Classical triad of PN was present in 87% of patients. Acute kidney injury was present in 47% of patients. Diabetes (69%) was the most common comorbid condition. Positive urine culture was found in 24% of patients. USG abdomen was performed in all patients and it was suggestive of APN in 66% cases. CT abdomen was available for 74% and it revealed PN in 70%, of patients. Among these Emphysematous PN (EPN) was found in 4% and renal abscess in 3% of patients.In this study, USG findings of PN were correlated with triad of PN symptoms and those who had PN for the first time.
Conclusion: In this study, majority of the patients presented with clinical triad of PN-fever, flank pain and dysuria. Urine culture was positive only in few cases. USG was able to diagnose large number of PN cases except emphysematous change and renal abscess which was detected by CT. The detection of PN was better with CT when compared to USG.