XGP/emphysematous Flashcards
XGP association
renal stones and obstruction
types XGP
focal
segmental
diffuse
causative organisms XGP
men vs women
ecoli, proteus - most common
occurs more often in women
histology of XGP
lipid laden foamy macrophages called xanthoma cells in parenchyma
diffuse infiltrate inflammatory cells
yellow nodules of pus
haemorrhagic necrosis in an enlarged kidney
histology of XGP
lipid laden foamy macrophages in parenchyma
yellow nodules of pus
haemorrhagic necrosis in an enlarged kidney
complications XGP
fistula
paranephric and psoas abscess
CT appearance XGP
low density parenchymal collections and a staghorn bear paw cortical thinning peri nephric fat inflammation hydronephrosis stones
emphysematous pyelo
definition
acute necrotizing renal parenchyma infection
intra parenchymal gas
acute necrotizing pyelonephritis caused by gas forming organisms with radiographic evidence of gas within or around kidney
diabetes assc >90% of cases
may be precipiated urinary obstruction stones, papillary necrosis
organisms emphysematous
mortality
ecoli
less often
kleb and proteus
40% mortality overall
types of emphysematous
Wan et al
classification based on CT
types of emphysematous
Wan et al
classification based on CT
Type 1 >1/3 renal parenchymal destruction, no fluid collections, streaky mottled gas radiating from medulla to cortex more likely death, mortality 60-70%
Type 2
<1/3 destruction parenchyma
bubbly loculated gas, in collecting system
mortality 20%
presentation emphysematous
pyelo that doesn’t respond within 72 hours IV abx
appearance of EP on axr
gas over kidney
cresecenteric over upper pole
definition XGP
severe renal infection resulting in diffuse parenchymal destruction and a non functioning kidney usually assciated with calculi
