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Acute Pyelonephritis
Katherine E. Maturen, MD, MS; Aya Kamaya, MD, FSRU, FSAR
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KEY FACTS

  • Imaging

    • Pathology

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Acute pyelonephritis (AP)
          • Definitions

            • Renal parenchymal infection 
            • Different from pyelitis (inflammation of renal pelvis) or pyonephrosis (infection plus collecting system obstruction)

          IMAGING

          • General Features

            • Ultrasonographic Findings

              • CT Findings

                • Nuclear Medicine Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Lee YJ et al: Unilateral and bilateral acute pyelonephritis: differences in clinical presentation, progress and outcome. Postgrad Med J. 90(1060):80-5, 2014
                                        2. Faletti R et al: Diffusion-weighted imaging and apparent diffusion coefficient values versus contrast-enhanced MR imaging in the identification and characterisation of acute pyelonephritis. Eur Radiol. 23(12):3501-8, 2013
                                        3. Fontanilla T et al: Acute complicated pyelonephritis: contrast-enhanced ultrasound. Abdom Imaging. 37(4):639-46, 2012
                                        4. Ifergan J et al: Imaging in upper urinary tract infections. Diagn Interv Imaging. 93(6):509-19, 2012
                                        5. Chen KC et al: The role of emergency ultrasound for evaluating acute pyelonephritis in the ED. Am J Emerg Med. 29(7):721-4, 2011
                                        6. Cavorsi K et al: Acute pyelonephritis. Ultrasound Q. 26(2):103-5, 2010
                                        7. Dell'Atti L et al: Clinical use of ultrasonography associated with color Doppler in the diagnosis and follow-up of acute pyelonephritis. Arch Ital Urol Androl. 82(4):217-20, 2010
                                        8. Craig WD et al: Pyelonephritis: radiologic-pathologic review. Radiographics. 28(1):255-77; quiz 327-8, 2008
                                        9. Demertzis J et al: State of the art: imaging of renal infections. Emerg Radiol. 14(1):13-22, 2007
                                        10. Browne RF et al: Imaging of urinary tract infection in the adult. Eur Radiol. 14 Suppl 3:E168-83, 2004
                                        11. Dacher JN et al: Power Doppler sonographic pattern of acute pyelonephritis in children: comparison with CT. AJR Am J Roentgenol. 166(6):1451-5, 1996
                                        12. Talner LB et al: Acute pyelonephritis: can we agree on terminology? Radiology. 192(2):297-305, 1994
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Imaging

                                          • Pathology

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Acute pyelonephritis (AP)
                                                • Definitions

                                                  • Renal parenchymal infection 
                                                  • Different from pyelitis (inflammation of renal pelvis) or pyonephrosis (infection plus collecting system obstruction)

                                                IMAGING

                                                • General Features

                                                  • Ultrasonographic Findings

                                                    • CT Findings

                                                      • Nuclear Medicine Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Lee YJ et al: Unilateral and bilateral acute pyelonephritis: differences in clinical presentation, progress and outcome. Postgrad Med J. 90(1060):80-5, 2014
                                                                              2. Faletti R et al: Diffusion-weighted imaging and apparent diffusion coefficient values versus contrast-enhanced MR imaging in the identification and characterisation of acute pyelonephritis. Eur Radiol. 23(12):3501-8, 2013
                                                                              3. Fontanilla T et al: Acute complicated pyelonephritis: contrast-enhanced ultrasound. Abdom Imaging. 37(4):639-46, 2012
                                                                              4. Ifergan J et al: Imaging in upper urinary tract infections. Diagn Interv Imaging. 93(6):509-19, 2012
                                                                              5. Chen KC et al: The role of emergency ultrasound for evaluating acute pyelonephritis in the ED. Am J Emerg Med. 29(7):721-4, 2011
                                                                              6. Cavorsi K et al: Acute pyelonephritis. Ultrasound Q. 26(2):103-5, 2010
                                                                              7. Dell'Atti L et al: Clinical use of ultrasonography associated with color Doppler in the diagnosis and follow-up of acute pyelonephritis. Arch Ital Urol Androl. 82(4):217-20, 2010
                                                                              8. Craig WD et al: Pyelonephritis: radiologic-pathologic review. Radiographics. 28(1):255-77; quiz 327-8, 2008
                                                                              9. Demertzis J et al: State of the art: imaging of renal infections. Emerg Radiol. 14(1):13-22, 2007
                                                                              10. Browne RF et al: Imaging of urinary tract infection in the adult. Eur Radiol. 14 Suppl 3:E168-83, 2004
                                                                              11. Dacher JN et al: Power Doppler sonographic pattern of acute pyelonephritis in children: comparison with CT. AJR Am J Roentgenol. 166(6):1451-5, 1996
                                                                              12. Talner LB et al: Acute pyelonephritis: can we agree on terminology? Radiology. 192(2):297-305, 1994