pyelonephritis

Summary

Summary: Inflammation of the KIDNEY involving the renal parenchyma (the NEPHRONS); KIDNEY PELVIS; and KIDNEY CALICES. It is characterized by ABDOMINAL PAIN; FEVER; NAUSEA; VOMITING; and occasionally DIARRHEA.

Top Publications

  1. Leroy S, Fernández Lopez A, Nikfar R, Romanello C, Bouissou F, Gervaix A, et al. Association of procalcitonin with acute pyelonephritis and renal scars in pediatric UTI. Pediatrics. 2013;131:870-9 pubmed publisher
    ..UTIs) are common childhood bacterial infections that may involve renal parenchymal infection (acute pyelonephritis [APN]) followed by late scarring...
  2. Yoon H, Chun J, Kim J, Kang S, Na D. Gardnerella vaginalis septicaemia with pyelonephritis, infective endocarditis and septic emboli in the kidney and brain of an adult male. Int J STD AIDS. 2010;21:653-7 pubmed publisher
    ..Here we report a case of G. vaginalis septicaemia with infective endocarditis and septic emboli in the kidney and brain of an adult male...
  3. Kim S, Kim Y, Lee H. Serious acute pyelonephritis: a predictive score for evaluation of deterioration of treatment based on clinical and radiologic findings using CT. Acta Radiol. 2012;53:233-8 pubmed publisher
    Acute pyelonephritis (APN) requires prompt diagnosis and immediate treatment.
  4. Colgan R, Williams M, Johnson J. Diagnosis and treatment of acute pyelonephritis in women. Am Fam Physician. 2011;84:519-26 pubmed
    Acute pyelonephritis is a common bacterial infection of the renal pelvis and kidney most often seen in young adult women. History and physical examination are the most useful tools for diagnosis...
  5. Lumbiganon P, Laopaiboon M, Thinkhamrop J. Screening and treating asymptomatic bacteriuria in pregnancy. Curr Opin Obstet Gynecol. 2010;22:95-9 pubmed publisher
    Asymptomatic bacteriuria (ASB) in pregnancy, if left undiagnosed and appropriately treated can lead to acute pyelonephritis in mothers and low birth weight in infants. Urine culture is the gold standard for diagnosing ASB...
  6. Gade C, Borup K. [Emphysematous pyelonephritis]. Ugeskr Laeger. 2010;172:220-2 pubmed
    Emphysematous pyelonephritis (EPN) is a rare, life-threatening infection of the kidney, characterized by production of gas within the renal parenchyma or perinephric tissue...
  7. Takahashi S, Kurimura Y, Takeyama K, Hashimoto K, Miyamoto S, Ichihara K, et al. Efficacy of treatment with carbapenems and third-generation cephalosporins for patients with febrile complicated pyelonephritis. J Infect Chemother. 2009;15:390-5 pubmed publisher
    ..the clinical relevance of carbapenem and third-generation cephalosporin treatment for febrile complicated pyelonephritis, which often leads to urosepsis...
  8. Cheng C, Tsau Y, Lin T. Is acute lobar nephronia the midpoint in the spectrum of upper urinary tract infections between acute pyelonephritis and renal abscess?. J Pediatr. 2010;156:82-6 pubmed publisher
    To examine acute lobar nephronia (ALN) in the spectrum of upper urinary tract infections between acute pyelonephritis (APN) and renal abscess.
  9. Ubee S, McGlynn L, Fordham M. Emphysematous pyelonephritis. BJU Int. 2011;107:1474-8 pubmed publisher
    Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the renal parenchyma. The clinical course of EPN can be severe and life-threatening if not recognized and treated promptly...

Scientific Experts

More Information

Publications62

  1. Jolley J, Kim S, Wing D. Acute pyelonephritis and associated complications during pregnancy in 2006 in US hospitals. J Matern Fetal Neonatal Med. 2012;25:2494-8 pubmed publisher
    To describe the occurrence of hospitalization for acute pyelonephritis during pregnancy and associated complications in 2006 in USA.
  2. Mittal R, Sharma S, Chhibber S, Harjai K. Evaluation of interleukin-10 production in Pseudomonas aeruginosa induced acute pyelonephritis. J Infect Public Health. 2009;2:136-40 pubmed publisher
    ..IL-10) production in mouse renal tissue was studied employing experimental mouse model of acute pyelonephritis induced with planktonic and biofilm cells of P. aeruginosa...
  3. Sledzinska A, Mielech A, Krawczyk B, Samet A, Nowicki B, Nowicki S, et al. Fatal sepsis in a pregnant woman with pyelonephritis caused by Escherichia coli bearing Dr and P adhesins: diagnosis based on postmortem strain genotyping. BJOG. 2011;118:266-9 pubmed publisher
  4. Cosentini V, Cosaro A, Gammaro L, Lidestri V, Oldrizzi L, Maschio G. [Escherichia coli-induced emphysematous pyelonephritis in a diabetic patient with polycystic kidney disease]. G Ital Nefrol. 2011;28:85-8 pubmed
    Emphysematous pyelonephritis is a rare, necrotizing infection of the kidney and the perirenal space resulting in the formation of gas in both structures and associated with a high mortality rate...
  5. Solak Y, Turkmen K, Atalay H, Turk S. Culture-negative bilateral emphysematous pyelonephritis presented as acute renal failure and managed medically only. South Med J. 2010;103:154-5 pubmed
    Emphysematous pyelonephritis is a life-threatening infection especially seen in patients with poorly-controlled diabetes mellitus. Imaging modalities (preferably computed tomography) are required to establish the diagnosis...
  6. Shigemura K, Yasufuku T, Yamashita M, Arakawa S, Fujisawa M. Bilateral emphysematous pyelonephritis cured by antibiotics alone: a case and literature review. Jpn J Infect Dis. 2009;62:206-8 pubmed
    Emphysematous pyelonephritis (EPN) is a rare but severe infectious disease. This disease sometimes presents bilaterally, making it difficult to cure. Diabetes mellitus is a common cofactor in this disease...
  7. Yamamoto Y, Fujita K, Nakazawa S, Hayashi T, Tanigawa G, Imamura R, et al. Clinical characteristics and risk factors for septic shock in patients receiving emergency drainage for acute pyelonephritis with upper urinary tract calculi. BMC Urol. 2012;12:4 pubmed publisher
    Acute pyelonephritis (APN) is a common complication of ureteral obstruction caused by urolithiasis, and it can be lethal if it progresses to septic shock...
  8. Spencer J, Hains D, Porter E, Bevins C, DiRosario J, Becknell B, et al. Human alpha defensin 5 expression in the human kidney and urinary tract. PLoS ONE. 2012;7:e31712 pubmed publisher
    ..Here, we characterize the expression and relevance of the AMP human alpha-defensin 5 (HD5) in the human kidney and urinary tract in normal and infected subjects...
  9. Mohsin N, Budruddin M, Lala S, Al Taie S. Emphysematous pyelonephritis: a case report series of four patients with review of literature. Ren Fail. 2009;31:597-601 pubmed
    Emphysematous pyelonephritis (EPN) is an acute necrotizing infection with gas presence in the kidney, perinephric space, and/or urinary collecting system that carries a bad prognosis...
  10. Ha Y, Kang C, Joo E, Park S, Kang S, Wi Y, et al. Clinical implications of healthcare-associated infection in patients with community-onset acute pyelonephritis. Scand J Infect Dis. 2011;43:587-95 pubmed publisher
    Clinical and microbiological characteristics of healthcare-associated acute pyelonephritis (HCA-APN) have not been described in detail yet...
  11. Vollmann R, Schaffler G, Spreizer C, Quehenberger F, Schoellnast H. Clinical significance of periportal tracking as an extrarenal manifestation of acute pyelonephritis. Abdom Imaging. 2011;36:557-60 pubmed publisher
    The purpose of this study was to evaluate whether hepatic periportal tracking (PPT) in patients with acute pyelonephritis correlates with the severity of pyelonephritis.
  12. Akil I, Ozkinay F, Onay H, Canda E, Gumuser G, Kavukcu S. Assessment of Toll-like receptor-4 gene polymorphism on pyelonephritis and renal scar. Int J Immunogenet. 2012;39:303-7 pubmed publisher
    ..5% in the UTI group and in 15.1% of the control group. Forty patients showed pyelonephritis (PN) with scar tissue, 37 patients had PN without scars, and 35 patients had lower UTI. The TLR4 c...
  13. Dubey I, Agrawal V, Jain B. Five patients with emphysematous pyelonephritis. Iran J Kidney Dis. 2011;5:204-6 pubmed
    Emphysematous pyelonephritis is an acute necrotizing infection of the renal parenchyma, resulting in presence of gas within either in the collecting system or perinephric space...
  14. Fontanilla T, Minaya J, Cortes C, Hernando C, Arangüena R, Arriaga J, et al. Acute complicated pyelonephritis: contrast-enhanced ultrasound. Abdom Imaging. 2012;37:639-46 pubmed publisher
    Imaging is required if complication is suspected in acute pyelonephritis to assess the nature and extent of the lesions, and to detect underlying causes. The current imaging modality of choice in clinical practice is computed tomography...
  15. Chang C, Shun H, Chuang C. Hepatic portal venous gas induced by emphysematous pyelonephritis: a rare case in hemodialytic women. Am J Emerg Med. 2009;27:1171.e1-3 pubmed publisher
    ..on abdominal computed tomography, which implied a unilateral perirenal abscess (so-called emphysematous pyelonephritis)...
  16. Baraboutis I, Koukoulaki M, Belesiotou H, Platsouka E, Papastamopoulos V, Kontothanasis D, et al. Community-acquired methicillin-resistant Staphylococcus aureus as a cause of rapidly progressing pyelonephritis with pyonephrosis, necessitating emergent nephrectomy. Am J Med Sci. 2009;338:233-5 pubmed publisher
    ..Postoperatively, the patient was treated with intravenous vancomycin for 3 weeks and had a favorable outcome...
  17. Naber K, Llorens L, Kaniga K, Kotey P, Hedrich D, Redman R. Intravenous doripenem at 500 milligrams versus levofloxacin at 250 milligrams, with an option to switch to oral therapy, for treatment of complicated lower urinary tract infection and pyelonephritis. Antimicrob Agents Chemother. 2009;53:3782-92 pubmed publisher
    ..Patients (n = 753) with complicated lower UTI or pyelonephritis were randomly assigned to receive IV doripenem at 500 mg every 8 h (q8h) or IV levofloxacin at 250 mg q24h...
  18. Lee J, Lee Y, Cho J. Risk factors of septic shock in bacteremic acute pyelonephritis patients admitted to an ER. J Infect Chemother. 2012;18:130-3 pubmed publisher
    Our objective was to identify factors associated with septic shock in patients with bacteremic acute pyelonephritis who were admitted to our emergency department (ER)...
  19. Lee Y, Lee J, Park Y. Risk factors for renal scar formation in infants with first episode of acute pyelonephritis: a prospective clinical study. J Urol. 2012;187:1032-6 pubmed publisher
    We prospectively determined the risk factors for renal scar formation after the first episode of acute pyelonephritis as confirmed on dimercapto-succinic acid scintigraphy in children younger than 1 year.
  20. Gil Ruiz M, Alcaraz A, Marañón R, Navarro N, Huidobro B, Luque A. Electrolyte disturbances in acute pyelonephritis. Pediatr Nephrol. 2012;27:429-33 pubmed publisher
    ..whether renal unresponsiveness to aldosterone associated with hyperkalemia is present in infants with acute pyelonephritis in the absence of significant urinary tract anomalies and to describe the clinical characteristics of patients ..
  21. Farkash E, Weintraub A, Sergienko R, Wiznitzer A, Zlotnik A, Sheiner E. Acute antepartum pyelonephritis in pregnancy: a critical analysis of risk factors and outcomes. Eur J Obstet Gynecol Reprod Biol. 2012;162:24-7 pubmed publisher
    To test the incidence and sonographic parameters of pyelonephritis during pregnancy, and to examine risk factors and pregnancy outcomes of women with acute antepartum pyelonephritis.
  22. Mohkam M, Karimi A, Habibian S, Sharifian M. Urinary N-acetyl-beta-D-glucosaminidase as a diagnostic marker of acute pyelonephritis in children. Iran J Kidney Dis. 2008;2:24-8 pubmed
    Prompt diagnosis and localization of pyelonephritis are of great importance in children...
  23. Brumbaugh A, Smith S, Mobley H. Immunization with the yersiniabactin receptor, FyuA, protects against pyelonephritis in a murine model of urinary tract infection. Infect Immun. 2013;81:3309-16 pubmed publisher
    ..Together, these iron receptor antigens will facilitate the development of a broadly protective, multivalent UTI vaccine to effectively target diverse strains of UPEC. ..
  24. Kudinha T, Johnson J, Andrew S, Kong F, Anderson P, Gilbert G. Distribution of phylogenetic groups, sequence type ST131, and virulence-associated traits among Escherichia coli isolates from men with pyelonephritis or cystitis and healthy controls. Clin Microbiol Infect. 2013;19:E173-80 pubmed publisher
    ..factor (VF) genes, major phylogenetic groups, sequence type ST131, and UTI-associated O antigens among 101 pyelonephritis, 153 cystitis and 135 fecal healthy control E...
  25. Claessens Y, Schmidt J, Batard E, Grabar S, Jegou D, Hausfater P, et al. Can C-reactive protein, procalcitonin and mid-regional pro-atrial natriuretic peptide measurements guide choice of in-patient or out-patient care in acute pyelonephritis? Biomarkers In Sepsis (BIS) multicentre study. Clin Microbiol Infect. 2010;16:753-60 pubmed publisher
    ..of adult patients with infectious disorders, their usefulness has not been established in the setting of acute pyelonephritis. To assess the effectiveness of CRP, PCT and ANP measurements in guiding emergency physicians' decisions ..
  26. Sandberg T, Skoog G, Hermansson A, Kahlmeter G, Kuylenstierna N, Lannergård A, et al. Ciprofloxacin for 7 days versus 14 days in women with acute pyelonephritis: a randomised, open-label and double-blind, placebo-controlled, non-inferiority trial. Lancet. 2012;380:484-90 pubmed publisher
    Acute pyelonephritis is a common infection in adult women, but there is a paucity of controlled trials of its treatment and the optimum duration of antibiotic treatment has not been properly defined...
  27. Soto E, Romero R, Vaisbuch E, Erez O, Mazaki Tovi S, Kusanovic J, et al. Fragment Bb: evidence for activation of the alternative pathway of the complement system in pregnant women with acute pyelonephritis. J Matern Fetal Neonatal Med. 2010;23:1085-90 pubmed publisher
    b>Pyelonephritis during pregnancy is associated with a more severe course than in the non-pregnant state. This has been attributed to an increased susceptibility of pregnant women to microbial products...
  28. Mohkam M, Karimi A, Karimi H, Sharifian M, Armin S, Dalirani R, et al. Urinary interleukin-8 in acute pyelonephritis of children: a before-after study. Iran J Kidney Dis. 2008;2:193-6 pubmed
    The aim of this study was to assess urinary interleukin-8 (IL-8) levels in pyelonephritis and its relation with the clinical course of the infection and of inflammatory changes detected by renal scintigraphy.
  29. Lee D, Jeon S, Lee C, Lee S, Kim J, Chang S. Acute pyelonephritis: clinical characteristics and the role of the surgical treatment. J Korean Med Sci. 2009;24:296-301 pubmed publisher
    The epidemiology of acute pyelonephritis (APN) has changed with time...
  30. Ferjani S, Saidani M, Ennigrou S, Hsairi M, Ben Redjeb S. Virulence determinants, phylogenetic groups and fluoroquinolone resistance in Escherichia coli isolated from cystitis and pyelonephritis. Pathol Biol (Paris). 2012;60:270-4 pubmed publisher
    The aim of this study is to assess the relation between virulence genotype, phylogenetic group and susceptibility to fluoroquinolones and the urinary tract infection type including pyelonephritis and cystitis due to Escherichia coli.
  31. Gupta K, Hooton T, Naber K, Wullt B, Colgan R, Miller L, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52:e103-20 pubmed publisher
    ..The focus of this work is treatment of women with acute uncomplicated cystitis and pyelonephritis, diagnoses limited in these guidelines to premenopausal, non-pregnant women with no known urological ..
  32. McGready R, Wuthiekanun V, Ashley E, Tan S, Pimanpanarak M, Viladpai nguen S, et al. Diagnostic and treatment difficulties of pyelonephritis in pregnancy in resource-limited settings. Am J Trop Med Hyg. 2010;83:1322-9 pubmed publisher
    Limited microbiology services impede adequate diagnosis and treatment of common infections such as pyelonephritis in resource-limited settings...
  33. Nikfar R, Khotaee G, Ataee N, Shams S. Usefulness of procalcitonin rapid test for the diagnosis of acute pyelonephritis in children in the emergency department. Pediatr Int. 2010;52:196-8 pubmed publisher
    ..Urinary tract infection (UTI) is a common problem in children. The aim of this study was to determine the usefulness of the procalcitonin (PCT) rapid test in the diagnosis of renal involvement in children with urinary tract infection...
  34. Jolley J, Wing D. Pyelonephritis in pregnancy: an update on treatment options for optimal outcomes. Drugs. 2010;70:1643-55 pubmed publisher
    Acute pyelonephritis is one of the most common indications for antepartum hospitalization. When acute pyelonephritis is diagnosed, conventional treatment includes intravenous fluid and parenteral antibacterial administration...
  35. Vouloumanou E, Rafailidis P, Kazantzi M, Athanasiou S, Falagas M. Early switch to oral versus intravenous antimicrobial treatment for hospitalized patients with acute pyelonephritis: a systematic review of randomized controlled trials. Curr Med Res Opin. 2008;24:3423-34 pubmed
    Acute pyelonephritis is a common infection with significant morbidity and mortality, particularly in pediatric populations...
  36. Cheng C, Tsau Y, Kuo C, Su L, Lin T. Comparison of extended virulence genotypes for bacteria isolated from pediatric patients with urosepsis, acute pyelonephritis, and acute lobar nephronia. Pediatr Infect Dis J. 2010;29:736-40 pubmed publisher
    ..This study was conducted to explore and differentiate bacterial virulence factors associated with urosepsis and 2 other severe parenchymal infections, acute pyelonephritis (APN) and acute lobar nephronia (ALN), in pediatric patients.
  37. Fischer H, Lutay N, Ragnarsdottir B, Yadav M, Jonsson K, Urbano A, et al. Pathogen specific, IRF3-dependent signaling and innate resistance to human kidney infection. PLoS Pathog. 2010;6:e1001109 pubmed publisher
    ..Host susceptibility to common infections like UTI may thus be strongly influenced by single gene modifications affecting the innate immune response...
  38. Ayazi P, Moshiri S, Mahyar A, Moradi M. The effect of vitamin A on renal damage following acute pyelonephritis in children. Eur J Pediatr. 2011;170:347-50 pubmed publisher
    ..study was to determine the effect of vitamin A on the rate of permanent renal damage in children with acute pyelonephritis. Fifty children, median age of 24 months (range 2-144), with first-time pyelonephritis verified by an uptake ..
  39. Ender P, Gajanana D, Johnston B, Clabots C, Tamarkin F, Johnson J. Transmission of an extended-spectrum-beta-lactamase-producing Escherichia coli (sequence type ST131) strain between a father and daughter resulting in septic shock and Emphysematous pyelonephritis. J Clin Microbiol. 2009;47:3780-2 pubmed publisher
    ..The father developed severe, recurrent pyelonephritis with multiple small abscesses; the daughter later developed septic shock, bacteremia, and extensive ..
  40. Chan T, Wu M, Suk F, Chen C, Chen Y, Hou Y, et al. Enterococcus hirae-related acute pyelonephritis and cholangitis with bacteremia: an unusual infection in humans. Kaohsiung J Med Sci. 2012;28:111-4 pubmed publisher
    ..We report two patients with E hirae bacteremia caused by acute pyelonephritis and acute cholangitis. The clinical courses have been smooth on use of sensitive antibiotic therapy...
  41. Campos J, Alende R, Gonzalez Quintela A. Abnormalities in aminotransferase levels during acute pyelonephritis. Eur J Intern Med. 2009;20:e53-6 pubmed publisher
    ..The study was aimed at investigating the alterations in aminotransferase levels during acute pyelonephritis in adults. Serum aminotransferases (AST and ALT) were determined in 421 patients (aged 16-90 years, 79...
  42. Scholes D, Hawn T, Roberts P, Li S, Stapleton A, Zhao L, et al. Family history and risk of recurrent cystitis and pyelonephritis in women. J Urol. 2010;184:564-9 pubmed publisher
    Recurrent urinary tract infections and pyelonephritis have risk factors suggesting genetic sources. Family history variables indicative of genetic risk merit further investigation...
  43. Lee S, Kim Y, Chung D. Impact of discordant empirical therapy on outcome of community-acquired bacteremic acute pyelonephritis. J Infect. 2011;62:159-64 pubmed publisher
    ..As ciprofloxacin resistance rate of Escherichia coli causing urinary tract infections has been increasing, concern about inappropriate empirical therapy has been arisen...
  44. Parvex P, Willi J, Kossovsky M, Girardin E. Longitudinal analyses of renal lesions due to acute pyelonephritis in children and their impact on renal growth. J Urol. 2008;180:2602-6; discussion 2606 pubmed publisher
    Acute pyelonephritis is a common condition in children, and can lead to renal scarring. The aim of this study was to analyze the progression of renal scarring with time and its impact on renal growth.
  45. Sharifian M, Ahmadi M, Karimi A, Zand R, Moghadar R, Ahmadi R, et al. Urinary endothellin-1 level in children with pyelonephritis and hydronephrosis. Saudi J Kidney Dis Transpl. 2013;24:731-6 pubmed
    ..Urinary ET-1 could be a useful marker that can be utilized in young children for diagnosis of hydronephrosis, especially obstructive cases. ..
  46. Chishti A, Maul E, Nazario R, Bennett J, Kiessling S. A guideline for the inpatient care of children with pyelonephritis. Ann Saudi Med. 2010;30:341-9 pubmed publisher
    Febrile urinary tract infections and pyelonephritis are common in children and frequently lead to hospitalization for management, especially in the child who appears toxic...
  47. Kapoor R, Muruganandham K, Gulia A, Singla M, Agrawal S, Mandhani A, et al. Predictive factors for mortality and need for nephrectomy in patients with emphysematous pyelonephritis. BJU Int. 2010;105:986-9 pubmed publisher
    To analyse the factors predicting the mortality and need for nephrectomy in patients with emphysematous pyelonephritis (EPN).
  48. Khaira A, Gupta A, Rana D, Gupta A, Bhalla A, Khullar D. Retrospective analysis of clinical profile prognostic factors and outcomes of 19 patients of emphysematous pyelonephritis. Int Urol Nephrol. 2009;41:959-66 pubmed publisher
    ..to study the clinical profile, prognostic factors, and the 6-month outcome of patients with emphysematous pyelonephritis (EPN) METHODS: All patients admitted with a diagnosis of emphysematous pyelonephritis between January 2001 and ..
  49. Wagenlehner F, Wagenlehner C, Redman R, Weidner W, Naber K. Urinary bactericidal activity of Doripenem versus that of levofloxacin in patients with complicated urinary tract infections or pyelonephritis. Antimicrob Agents Chemother. 2009;53:1567-73 pubmed publisher
    ..of intravenous levofloxacin (250 mg q24h) in patients with complicated urinary tract infections (cUTIs) or pyelonephritis. UBTs and AUBTs are pharmacokinetic/pharmacodynamic parameters able to reflect the activity of an ..
  50. Kyriakidou K, Rafailidis P, Matthaiou D, Athanasiou S, Falagas M. Short- versus long-course antibiotic therapy for acute pyelonephritis in adolescents and adults: a meta-analysis of randomized controlled trials. Clin Ther. 2008;30:1859-68 pubmed publisher
    Despite the high incidence of acute pyelonephritis in the community setting, there is no consensus on the optimal duration of treatment...
  51. Lim S, Park I, Lee W, Kim H, Choi Y. Change of antimicrobial susceptibility among Escherichia coli strains isolated from female patients with community-onset acute pyelonephritis. Yonsei Med J. 2012;53:164-71 pubmed publisher
    There is a concern on which antimicrobials are appropriate as empirical agents for community-onset acute pyelonephritis (APN) in regions where the fluoroquinolone resistance rate is high, such as in Korea.
  52. Chen S, Chang H, Hung T, Chao Y, Tsai J, Lue K, et al. Diagnostic performance of procalcitonin for hospitalised children with acute pyelonephritis presenting to the paediatric emergency department. Emerg Med J. 2013;30:406-10 pubmed publisher
    ..This study prospectively assessed the diagnostic performance of procalcitonin (PCT) for predicting acute pyelonephritis (APN) among children with febrile UTI presenting to the paediatric emergency department (ED).
  53. Pichon C, Héchard C, du Merle L, Chaudray C, Bonne I, Guadagnini S, et al. Uropathogenic Escherichia coli AL511 requires flagellum to enter renal collecting duct cells. Cell Microbiol. 2009;11:616-28 pubmed publisher
    ..We investigated the ability of 13 E. coli strains isolated from the urine of patients with pyelonephritis and cystitis and normal stools to invade collecting duct cells, which constitute the first epithelium ..