1064 CAN COMPUTERIZED TOMOGRAPHY (CT) SCANS FOR ACUTE PYELONEPHRITIS BE USEFUL FOR PREDICTING THE TREATMENT OUTCOME?

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder (I)1 Apr 20131064 CAN COMPUTERIZED TOMOGRAPHY (CT) SCANS FOR ACUTE PYELONEPHRITIS BE USEFUL FOR PREDICTING THE TREATMENT OUTCOME? Seung Hwan Lee, Kwang Hyun Kim, Kyung Kgi Park, Dong Hoon Lee, and Byung Ha Chung Seung Hwan LeeSeung Hwan Lee Seoul, Korea, Republic of More articles by this author , Kwang Hyun KimKwang Hyun Kim Seoul, Korea, Republic of More articles by this author , Kyung Kgi ParkKyung Kgi Park Seoul, Korea, Republic of More articles by this author , Dong Hoon LeeDong Hoon Lee Seoul, Korea, Republic of More articles by this author , and Byung Ha ChungByung Ha Chung Seoul, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.650AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Many cases of acute pyelonephritis (APN) show renal perfusion defects on contrast enhanced computerized tomography (CT) imaging studies. We investigated the frequency of renal perfusion defects in uncomplicated APN and compared the clinical responses according to degree of renal perfusion defects. METHODS We studied patients who had symptoms and signs of acute pyelonephritis through CT examinations with contrast enhancement. We identified 373 cases who had perfusion defects among 402 patients who had undergone CT imaging studies. We classified CT findings of group 1 as focal unilateral, multifocal unilateral (group 2) and multifocal bilateral (group 3) and compared the clinical data and factors influencing treatment outcome. RESULTS Most patients were women (N=366, 98%) and had typical symptoms and signs of APN (N=361, 97%) such as high fever and chill, flank pain and costovertebral angle tenderness. There were 139 (37.3%) of 373 cases in group 1, 172 (47.6%) in group 2 and 62 (16.6%) in group3. On urinalysis, 241(64.6%) cases had positive bacterial cultures with Escherichia coli 179 (48.1%) being the most common pathogen. All the patients were treated with broad-spectrum intravenous antibiotics alone. The duration of recovery of pyuria in group 1 (2.7±2.6 days) was shorter than in group 2 (4.6±3.0 days) and group 3 (5.3±2.4days). The length of hospital stay raged from 2 to 19 days (mean 4.8 days). There was a significant correlation between multiple perfusion defects on CT scan and length of hospital stay (P=0.008). CONCLUSIONS Patients who had multiple perfusion defects on CT scan showed relatively severe clinical courses and longer hospital stay. Contrast enhanced CT scans may be very sensitive for the detection of acute renal parenchymal inflammatory disease and for defining the extent of disease. Therefore, clinical use of contrast enhanced CT scan may be helpful for predicting the prognosis of APN. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e436-e437 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Seung Hwan Lee Seoul, Korea, Republic of More articles by this author Kwang Hyun Kim Seoul, Korea, Republic of More articles by this author Kyung Kgi Park Seoul, Korea, Republic of More articles by this author Dong Hoon Lee Seoul, Korea, Republic of More articles by this author Byung Ha Chung Seoul, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...