Pyelonephritis

Pyelonephritis is an ascending urinary tract infection that has reached the pelvis of the kidney. Severe cases of pyelonephritis can lead to pyonephrosis (pus accumulation around the kidney), urosepsis (a systemic inflammatory response of the body to infection), kidney failure and even death.

Usually, pyelonephritis manifests itself with the following symptoms: fever, accelerated heart rate, painful urination, abdominal pain radiating to the back, nausea, and tenderness at the costovertebral angle on the affected side. If pyelonephritis has progressed to urosepsis, it may be accompanied by signs of septic shock, including rapid breathing, decreased blood pressure, violent shivering, and occasionally delirium.

Classification. Pyelonephritis can be acute, chronic or xanthogranulomatous.

Acute pyelonephritis is an exudative purulent localized inflammation of the renal pelvis and kidney. Gross pathology often reveals pathognomonic radiations of bleeding and suppuration through the renal pelvis to the renal cortex.

Chronic pyelonephritis implies recurrent kidney infections, and can result in scarring of the renal parenchyma and impaired function, especially in the setting of obstruction. A perinephric abscess (infection around the kidney) and/or pyonephrosis may develop in severe cases of pyelonephritis.

Xanthogranulomatous pyelonephritis is an unusual form of chronic pyelonephritis characterized by granulomatous abscess formation and severe kidney destruction. A clinical picture may resemble renal cell carcinoma and other inflammatory renal parenchymal diseases. Most patients complain of recurrent fevers and urosepsis, anemia, and a painful renal mass. Other common manifestations include kidney stones and loss of function of the affected kidney.

To determine pyelonephritis the following examinations are necessary to make: urinalysis to show the signs of urinary tract infection; a urine test strip to reveal the presence of nitrite and white blood cells; blood tests; microbiological culture of the urine and antibiotic sensitivity testing.

Pyelonephritis requires antibiotic therapy, and sometimes surgical intervention such as percutaneous nephrostomy or percutaneous nephrolithotomy, as well as treatment of any underlying causes to prevent its recurrence.

Exercise 5. Answer the questions:

1. What is pyelonephritis?

2. What can it lead to?

3. What are the symptoms of pyelonephritis?

4. What happens if pyelonephritis has progressed to urosepsis?

5. What are the types of pyelonephritis?

6. How does acute pyelonephritis manifest itself?

7. What can chronic pyelonephritis result in?

8. What is the clinical picture of xanthogranulomatous pyelonephritis?

9. What examinations are necessary to make to determine pyelonephritis?

10. How is pyelonephritis treated?

Exercise 6. Give the English equivalents:

висхідна сечова інфекція, ниркова миска, серйозні випадки пієлонефриту, болісне сечовипускання, черевний біль, швидке дихання, сильне тремтіння, марення, гнійне локалізоване запалення, значна деструкція нирки, лікування антибіотиками, хірургічне втручання.

Exercise 7. Match the corresponding pairs:

1. urinary	a. blood pressure
2.renal	b. inflammation
3.accelerated	c. culture
4.white	d. shivering
5.dicreased	e. stones
6. antibiotic	f. heart rate
7.microbial	g. therapy
8.kidney	h. blood cells
9.purulent	i. infection
10.violent	j. pelvis

Exercise 8. Find synonyms to the following words:

treatment –	hemorrhage –
sharp –	purulence –
reaction –	occlusion –
persistent –	cancer –
trembling –	to find out –

Exercise 9. Fill in the table:

English	Ukrainian	English	Ukrainian
1.	пієлонефрит	6.accumulation
2.UTI		7.	хірургічне втручання
3.	прискорене дихання	8.	підшкірний
4. pyonephrosis		9.delirium
5.	уражена нирка	10.antibiotic sensitivity

Exercise 10. Put questions to the underlined words:

Severe cases of pyelonephritis can lead to pyonephrosis, urosepsis, kidney failure and even death.

Pyelonephritis manifests itself with fever, painful urination, abdominal pain, etc.

Tenderness is one of many symptoms of pyelonephritis.

Pyelonephritis can be acute, chronic or xanthogranulomatous.

Chronic pyelonephritis can result in scarring of the renal parenchyma.

Xanthogranulomatous pyelonephritis is characterized by severe kidney destruction.

A clinical picture of xanthogranulomatous pyelonephritis may resemble renal cell carcinoma.

Patients with xanthogranulomatous pyelonephritis complain of urosepsis, anemia, painful renal mass.

Pyelonephritis requires antibiotic therapy and sometimes surgical intervention.

Another common manifestation of pyelonephritis includes kidney stones.

Exercise 11. Insert the prepositions/conjunctions where necessary:

1) Severe cases … pyelonephritis can lead …pyonephrosis, urosepsis, kidney failure and even death.

2) If pyelonephritis has progressed … urosepsis, it may be accompanied … signs … septic shock.

3) Gross pathology often reveals pathognomonic radiations of bleeding and suppuration … the renal pelvis … the renal cortex.

4) Xanthogranulomatous pyelonephritis is an unusual form of chronic pyelonephritis characterized … severe kidney destruction.

5) Chronic pyelonephritis can result … scarring of the renal parenchyma.

6) It can also result … the setting … obstruction.

7) A perinephric abscess and pyonephrosis may develop … severe cases … pyelonephritis.

8) Pyelonephritis requires antibiotic therapy, and sometimes surgical intervention … percutaneous nephrostomy or nephrolithotomy.

9) Other common manifestations include … kidney stones and loss … function of the affected kidney.

10) Usually, pyelonephritis manifests itself … such symptoms as painful urination, abdominal pain radiating to the back, nausea, etc.

Дата добавления: 2015-11-16