• Clinical and Experimental Pediatrics
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• 제62권12호
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• pp.433-437
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• 2019

Acute pyelonephritis (APN) should be detected and treated as soon as possible to reduce the risk of the development of acquired renal scarring. However, in the medical field, urine culture results are not available or considered when the prompt discrimination of APN is necessary and empirical treatment is started. Furthermore, urine culture cannot discriminate APN among children with febrile urinary tract infection (UTI) (pyelitis, lower UTI with other fever focus). Therefore, the usefulness of urine culture for diagnostic purposes is small and the sampling procedure is invasive. Congenital hypoplastic kidney is the most common cause of chronic kidney injury in children. Thus, it is desirable that a main target be detected as early as possible when imaging studies are performed in children with APN. However, if APN does not recur, no medical or surgical treatment or imaging studies would be needed because the acquired renal scar would not progress further. Therefore, the long-term prognosis of APN in young children, particularly infants, depends on the number of recurrent APN, not other febrile UTI. New methods that enable prompt, practical, and comfortable APN diagnosis in children are needed as alternatives to urinary catheterization for urine culture sampling.

• Journal of Yeungnam Medical Science
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• 제10권2호
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• pp.537-543
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• 1993

저자들은 당뇨병 환자에서 발생한 기종성 신우신염을 내과적 치료와 응급 신적출술로 성공적으로 치험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한한방내과학회지
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• 제39권5호
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• pp.949-954
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• 2018

Objective: This case reports the management of a chronic pyelonephritis patient treated with Hyeonsamjihwang-tang. Methods: The patient suffered from swelling and fatigue and was diagnosed with Soyangin Mangeum-syndrome. The patient was treated with Hyeonsamjihwang-tang for a 40 day period. Hematology, urinalysis, and the numerical rating scale were used to evaluate the effects. Results: After treatment with Hyeonsamjihwang-tang, the patient's complaints of symptoms decreased, and improvements were shown in hematology and urinalysis. Conclusions: Hyeonsamjihwang-tang has an effect on patients with chronic pyelonephritis.

• 사상체질의학회지
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• 제13권2호
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• pp.194-204
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• 2001

Purpose: In general, Acute Pyelonephritis is effectively treated with the use of antibiotics. However, some antibiotics are reported to cause side effects, and the abuse of antibiotics results in the increase of the disease's tolerance to antibiotics. Recently, I have effectively treated five cases of Acute Pyelonephritis by using only Constitution - Acupuncture and Herb, and therefore I would like to report about these cases. Methods: I diagnosed Acute Pyelonephritis of these five patients by confirming symptoms and employing a urine analysis with reagent strip(Multi $stix{\circledR}$). I used Kuon's method of constitutional diagnosis for the purpose of the diagnosis of the constitutional 8 morbidities. I relied on Sungjeong(性情) and Chehyungkisang(體刑氣像) in diagnosing Sasang Constitutions(四象人). I performed acupuncture on the left and right sides, depending on 8 constitutions, by employing Chang - temperament Inflammation Formula(臟系炎症方) that is used for the treatment of all kinds of chang-temperament inflammation diseases, as well as Bactericidal Formula(殺菌方) that is used for the treatment of all kinds of bacterially caused diseases. I prescribed by consulting the appearance of disease and general symptoms of each case with Dongyi Soose Bowon(東醫壽世保元)'s prescription symptoms. Result: Two of them showing severe symptoms were hospitalized, while three others took OPD treatment. The patient who was PANCREOTONIA and Soyangin improved through hospitalization for three days, another patient who was PULMOTONIA and Taeyangin with severe symptoms, improved through hospitalization for seven days, and completely recovered through OPD treatment later. The three others took only OPD treatment, and improved within 5-7 days. Conclusion: I confirmed that each of 8-constituions and Sasang Constitutions were all treated effectively without antibiotics.

• Infection and chemotherapy
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• 제50권4호
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• pp.357-361
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• 2018

While carbapenems are the drug of choice to treat extended-spectrum-${\beta}$-lactamase (ESBL)-producing strains, some alternative carbapenem-sparing regimens are suggested for antibiotic stewardship. We experienced a case of ciprofloxacin treatment failure for acute pyelonephritis caused by an apparently susceptible Escherichia coli. A 71-year-old woman presented the emergency department with fever for 7 days and bilateral flank pain for 2 days. The laboratory results and abdominopelvic computed tomography finding were compatible with acute pyelonephritis. During 3-day ciprofloxacin therapy, the patient remained febrile with persistent bacteremia. After the change in antibiotics to ertapenem, the patient's clinical course started to improve. ESBL-producing E. coli isolates were identified in all three consecutive blood samples. Pulsed-field gel electrophoresis (PFGE) patterns, serotypes, and sequence types showed the three isolates were derived from the identical strain. The isolates produced CTX-M-14 type ESBL belonging to the ST69 clonal group. Despite in vitro susceptibility, the failure was attributed to a gyrA point mutation encoding Ser83Leu within quinolone resistance-determining regions. This case suggests that ciprofloxacin should be used cautiously in the treatment of serious infections caused by ciprofloxacin-susceptible, ESBL-producing E. coli, even in acute pyelonephritis because in-vitro susceptibility tests could fail to detect certain genetic mutations.

• 대한한방내과학회지
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• 제41권6호
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• pp.1172-1179
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• 2020

Introduction: In this case report, we addressed the effects of a Korean medicine treatment on recurrent pyelonephritis in a female patient with a duplicated collecting system. Case report: A 22-year-old female with acute pyelonephritis was treated with Korean medicine, including herbal medication, Insampaedok-san plus Oryeong-san, and with antibiotic therapy. We evaluated the improvements in her symptoms by measuring C-reactive protein, WBC count, body temperature, and a numeric rating scale for nausea. The symptoms of fever and nausea improved after two days of hospitalization. From the 4th day of taking the herbal medicine, the antibiotic IV infusion was changed to oral agents. Conclusions: This clinical case study suggests that modified Insampaedok-san might have shortened the duration of intravenous antibiotic infusion and hospitalization for recurrent pyelonephritis in a female patient with a bifid ureter.

• Childhood Kidney Diseases
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• 제19권2호
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• pp.79-88
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• 2015

Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as one of the most promising biomarkers of renal epithelial injury. Numerous studies have presented the diagnostic and prognostic utility of urinary and plasma NGAL in patients with acute kidney injury, chronic kidney disease, renal injury after kidney transplantation, and other renal diseases. NGAL is a member of the lipocalin family that is abundantly expressed in neutrophils and monocytes/macrophages and is a mediator of the innate immune response. The biological significance of NGAL to hamper bacterial growth by sequestering iron-binding siderophores has been studied in a knock-out mouse model. Besides neutrophils, NGAL is detectable in most tissues normally encountered by microorganisms, and its expression is upregulated in epithelial cells during inflammation. A growing number of studies have supported the clinical utility of NAGL for detecting invasive bacterial infections. Several investigators including our group have reported that measuring NGAL can be used to help predict and manage urinary tract infections and acute pyelonephritis. This article summarizes the biology and pathophysiology of NGAL and reviews studies on the implications of NGAL in various renal diseases from acute kidney injury to acute pyelonephritis.

• 대한수의학회지
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• 제60권2호
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• pp.93-96
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• 2020

An 11-year-old female mixed-breed dog admitted due to anorexia and vomiting. Radiography showed 7.6-mm uroliths in the right proximal ureter and an enlarged kidney. Type 1 emphysematous pyelonephritis (EPN) was diagnosed using computed tomography (CT) in the awake dog. Right ureteronephrectomy was performed, and Escherichia coli was isolated. The stone was consisted of 80% calcium oxalate. At the 6-month follow-up, no complications were observed. This is the first report of EPN caused by calcium oxalate in a dog. In addition, we suggest performing CT in weak animals to diagnose EPN without anesthesia.

• Childhood Kidney Diseases
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• 제14권2호
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• pp.195-202
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• 2010

목 적 : 요로감염 환아에서 영구적 신장손상을 예측하기 위하여, 연령, 발열기간 및 농뇨 지속기간, 방광요관역류나 수신증 여부 등을 비교, 분석하였다. 방 법 : 2000년 1월부터 2005년 1월까지 아주대학교 병원에서 요로감염으로 입원한 환아 중 DMSA에서 신장 결손을 보인 160명의 환아를 대상으로 6개월 후 추적 DMSA에서 회복된 회복군과 반흔이 남은 반흔군으로 나누어 각각의 특징을 비교분석하였다. 결 과 : 전체 대상 환아 160명 중 106명이 추적 DMSA에서 회복을 보였고, 54명이 반흔이 남아 33.8%의 발생률을 보였다. 반흔군에서 처음 진단 당시의 나이가1세 이상인 환자가 회복군에 비해 많았고(P=0.01), 발열기간, 농뇨지속 기간 등이 회복군에 비해 길었으며, 발열의 기왕력이 있었다. VCUG, Ultra-sound sonography에서도 반흔군이 회복군에 비해 비정상적 결과를 보인 경우가 많았다. 결 론 : 급성신우신염을 앓은 소아에서 감염당시 환아의 나이가 많을수록, 발열 기간이나 농뇨 지속 기간이 오래 될수록, 방광요관역류나 초음파검사 이상소견이 있는 초기 신결손이 신반흔으로 고착되는 경향을 확인할 수 있었다. 특히 잦은 발열 기왕력이 있는 경우 신손상 발생률이 높은 것을 볼 때, 이는 임상에서 미처 진단되지 못한, 혹은 잘 못 진단된 급성신우신염이 있음을 시사해 준다.

• Clinical and Experimental Pediatrics
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• 제61권2호
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• pp.64-67
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• 2018

We report the case of a 12-year-old girl who had mild encephalopathy with a reversible splenial lesion (MERS) associated with acutepyelonephritis caused by Escherichia coli. The patient was admitted with a high fever, and she was diagnosed with acute pyelonephritis based on pyuria and the results of urine culture, which detected cefotaxime-sensitive E. coli. Although intravenous cefotaxime and tobramycin were administered, her fever persisted and her C-reactive protein level increased to 307 mg/L. On day 3 of admission, she demonstrated abnormal neuropsychiatric symptoms, such as delirium, ataxia, and word salad. Magnetic resonance imaging (MRI) of the brain performed on day 4 showed marked hyperintensities in the bilateral corpus callosum and deep white matter on diffusion-weighted images, with corresponding diffusion restriction on apparent diffusion coefficient mapping. No abnormalities or pathogens were detected in the cerebrospinal fluid; however, lipopolysaccharides (LPS, endotoxin) were detected in plasma (41.6 pg/mL), associated with acute neurological deterioration. Her clinical condition gradually improved, and no neurological abnormalities were observed on day 6. Follow-up brain MRI performed 2 weeks later showed near-disappearance of the previously noted hyperintense lesions. In this patient, we first proved endotoxemia in a setting of MERS. The release of LPS following antibiotic administration might be related to the development of MERS in this patient. The possibility of MERS should be considered in patients who present with acute pyelonephritis and demonstrate delirious behavior.