"Klebsiella spp."
"DWI: round or wedge-shaped parenchymal areas hyperintense on DWI with corresponding low ADC due to oedema 9."
"Post-contrast CT"
"if imaged during the excretory phase, a striated nephrogram may also be visible 7,5"
"T1: affected region(s) appear hypointense compared with the normal kidney parenchyma"
"T2: hyperintense compared to normal kidney parenchyma"
"T1 C+: reduced enhancement"
"DWI: round or wedge-shaped parenchymal areas hyperintense on DWI with corresponding low ADC due to oedema 9."
"T1: affected region(s) appear hypointense compared with the normal kidney parenchyma"
"Technetium-99m dimercaptosuccinic acid (DMSA) demonstrates a similar reduction in renal perfusion and function, which appears as one or more patchy scintigraphy defects in the outline of the kidneys 6."
"Escherichia coli (most common)"
"Klebsiella spp."
"Proteus spp."
"Enterobacter spp."
"Pseudomonas spp."
"Haemophilus influenzae"
"Klebsiella spp."
"Proteus spp."
"Enterobacter spp."
"Pseudomonas spp."
"Haemophilus influenzae"
"perinephric stranding: although not considered a useful sign 8"
Expected headings
"Non-contrast CT"
"Post-contrast CT"
"Complications"
"Clinical presentation is fairly specific and classical in most cases, consisting of a rapid onset of high fever, flank pain and costovertebral angle tenderness (i.e. positive Murphy's kidney punch). In many instances, less specific symptoms such as nausea, vomiting, dysuria, urinary frequency, urgency and other non-specific signs may also be present 2,3."
"Ultrasound is, however, useful in assessing for local complications such as hydronephrosis, renal abscess formation, renal infarction, perinephric collections, and thus may guide management."
"Clinical presentation is fairly specific and classical in most cases, consisting of a rapid onset of high fever, flank pain and costovertebral angle tenderness (i.e. positive Murphy's kidney punch). In many instances, less specific symptoms such as nausea, vomiting, dysuria, urinary frequency, urgency and other non-specific signs may also be present 2,3."
"CT is a sensitive modality for evaluation of the renal tract, able to assess for renal calculi, gas, perfusion defects, collections and obstruction. Unfortunately, it does have a significant radiation burden and should be used sparingly, especially in young patients."
"Patients should be treated with antibiotics, analgesia and antipyretics 10. Empirical antibiotics should be commenced initially and adjusted accordingly to urine culture results. Most patients respond rapidly to appropriate oral antibiotic therapy, and often no imaging whatsoever is required. IV antibiotics are reserved for complicated cases of acute pyelonephritis."
"renal infarction, necrosis and scarring"
"There is usually no need for a three or four phase CT IVP (CT urography). A single 45-90 second post-contrast scan usually suffices, although clinical acumen may be necessary to choose the best contrast phase 2,7. For example, if renal colic is suspected then a non-contrast scan is often required to assess for renal calculi. If renal ischaemia is suspected then an arterial scan (15-25 seconds) is ideal to assess perfusion 7."
"the periphery of the cortex is also affected, helpful in distinguishing acute pyelonephritis from a renal infarct (which tends to spare the periphery; the so-called 'rim sign')"