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Acute Pyelonephritis
Ghaneh Fananapazir, MD, FSAR, FSRU, FSABI; Alessandro Furlan, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Acute infection of renal pelvis and parenchyma

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Ultrasonographic 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. Cruz J et al: Infectious and inflammatory diseases of the urinary tract: role of MR imaging. Magn Reson Imaging Clin N Am. 27(1):59-75, 2019
                                              2. Pierce C et al: Imaging in acute pyelonephritis: utilization, findings, and effect on management. South Med J. 112(2):118-24, 2019
                                              3. Udare A et al: Imaging manifestations of acute and chronic renal infection that mimics malignancy: how to make the diagnosis using computed tomography and magnetic resonance imaging. Can Assoc Radiol J. 70(4):424-43, 2019
                                              4. El-Merhi F et al: Qualitative and quantitative radiological analysis of non-contrast CT is a strong indicator in patients with acute pyelonephritis. Am J Emerg Med. 36(4):589-93, 2018
                                              5. Expert Panel on Urologic Imaging:. et al: ACR Appropriateness Criteria® acute pyelonephritis. J Am Coll Radiol. 15(11S):S232-9, 2018
                                              6. Lee A et al: Clinical usefulness of unenhanced computed tomography in patients with acute pyelonephritis. J Korean Med Sci. 33(38):e236, 2018
                                              7. Spital A: Acute pyelonephritis in adults. N Engl J Med. 378(12):1162, 2018
                                              8. Lee YJ et al: Unilateral and bilateral acute pyelonephritis: differences in clinical presentation, progress and outcome. Postgrad Med J. 90(1060):80-5, 2014
                                              9. Vivier PH et al: MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging. Eur Radiol. 24(1):19-25, 2014
                                              10. De Pascale A et al: Diffusion-weighted magnetic resonance imaging: new perspectives in the diagnostic pathway of non-complicated acute pyelonephritis. Eur Radiol. 23(11):3077-86, 2013
                                              11. 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
                                              12. Ghasemi K et al: Correlation of 99mTc-DMSA scan with radiological and laboratory examinations in childhood acute pyelonephritis: a time-series study. Int Urol Nephrol. 45(4):925-32, 2013
                                              13. Abraham G et al: Diagnosis of acute pyelonephritis with recent trends in management. Nephrol Dial Transplant. 27(9):3391-4, 2012
                                              14. Fontanilla T et al: Acute complicated pyelonephritis: contrast-enhanced ultrasound. Abdom Imaging. 37(4):639-46, 2012
                                              15. Martina MC et al: Dynamic magnetic resonance imaging in acute pyelonephritis. Radiol Med. 115(2):287-300, 2010
                                              16. Mitterberger M et al: Acute pyelonephritis: comparison of diagnosis with computed tomography and contrast-enhanced ultrasonography. BJU Int. 101(3):341-4, 2008
                                              17. Demertzis J et al: State of the art: imaging of renal infections. Emerg Radiol. 14(1):13-22, 2007
                                              18. Pertel PE et al: Risk factors for a poor outcome after therapy for acute pyelonephritis. BJU Int. 98(1):141-7, 2006
                                              19. Pickhardt PJ et al: From the archives of the AFIP. Infiltrative renal lesions: radiologic-pathologic correlation. Armed Forces Institute of Pathology. Radiographics. 20(1):215-43, 2000
                                              20. Talner LB et al: Acute pyelonephritis: can we agree on terminology? Radiology. 192:297-305, 1994
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Definitions

                                                            • Acute infection of renal pelvis and parenchyma

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic 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. Cruz J et al: Infectious and inflammatory diseases of the urinary tract: role of MR imaging. Magn Reson Imaging Clin N Am. 27(1):59-75, 2019
                                                                                          2. Pierce C et al: Imaging in acute pyelonephritis: utilization, findings, and effect on management. South Med J. 112(2):118-24, 2019
                                                                                          3. Udare A et al: Imaging manifestations of acute and chronic renal infection that mimics malignancy: how to make the diagnosis using computed tomography and magnetic resonance imaging. Can Assoc Radiol J. 70(4):424-43, 2019
                                                                                          4. El-Merhi F et al: Qualitative and quantitative radiological analysis of non-contrast CT is a strong indicator in patients with acute pyelonephritis. Am J Emerg Med. 36(4):589-93, 2018
                                                                                          5. Expert Panel on Urologic Imaging:. et al: ACR Appropriateness Criteria® acute pyelonephritis. J Am Coll Radiol. 15(11S):S232-9, 2018
                                                                                          6. Lee A et al: Clinical usefulness of unenhanced computed tomography in patients with acute pyelonephritis. J Korean Med Sci. 33(38):e236, 2018
                                                                                          7. Spital A: Acute pyelonephritis in adults. N Engl J Med. 378(12):1162, 2018
                                                                                          8. Lee YJ et al: Unilateral and bilateral acute pyelonephritis: differences in clinical presentation, progress and outcome. Postgrad Med J. 90(1060):80-5, 2014
                                                                                          9. Vivier PH et al: MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging. Eur Radiol. 24(1):19-25, 2014
                                                                                          10. De Pascale A et al: Diffusion-weighted magnetic resonance imaging: new perspectives in the diagnostic pathway of non-complicated acute pyelonephritis. Eur Radiol. 23(11):3077-86, 2013
                                                                                          11. 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
                                                                                          12. Ghasemi K et al: Correlation of 99mTc-DMSA scan with radiological and laboratory examinations in childhood acute pyelonephritis: a time-series study. Int Urol Nephrol. 45(4):925-32, 2013
                                                                                          13. Abraham G et al: Diagnosis of acute pyelonephritis with recent trends in management. Nephrol Dial Transplant. 27(9):3391-4, 2012
                                                                                          14. Fontanilla T et al: Acute complicated pyelonephritis: contrast-enhanced ultrasound. Abdom Imaging. 37(4):639-46, 2012
                                                                                          15. Martina MC et al: Dynamic magnetic resonance imaging in acute pyelonephritis. Radiol Med. 115(2):287-300, 2010
                                                                                          16. Mitterberger M et al: Acute pyelonephritis: comparison of diagnosis with computed tomography and contrast-enhanced ultrasonography. BJU Int. 101(3):341-4, 2008
                                                                                          17. Demertzis J et al: State of the art: imaging of renal infections. Emerg Radiol. 14(1):13-22, 2007
                                                                                          18. Pertel PE et al: Risk factors for a poor outcome after therapy for acute pyelonephritis. BJU Int. 98(1):141-7, 2006
                                                                                          19. Pickhardt PJ et al: From the archives of the AFIP. Infiltrative renal lesions: radiologic-pathologic correlation. Armed Forces Institute of Pathology. Radiographics. 20(1):215-43, 2000
                                                                                          20. Talner LB et al: Acute pyelonephritis: can we agree on terminology? Radiology. 192:297-305, 1994