ABSTRACT
A 23-year-old student nurse presented with polymicrobial bacteremia and symptoms suggestive of a renal abscess. After extensive evaluation, including an exploratory laparotomy, failed to reveal the source of sepsis, factitious illness owing to self-inoculation was suspected. In the absence of urologic, biliary or gastrointestinal obstruction self-inoculation must be considered in all patients with polymicrobial bacteremia.
Subject(s)
Factitious Disorders , Sepsis/etiology , Adult , Female , HumansABSTRACT
Chronic pyelonephritis secondary to vesicoureteral reflux has been shown to cause occasionally systemic hypertension. The hypertension may occur in the presence or absence of bacterial urinary infection, is renin-mediated and may develop years after ureteral reimplantation. Surgical excision of a scarred atrophic renin-producing segment may result in amelioration of the hypertension or at least provide better medical control with less toxic antihypertensive agents. Surgical removal of renal tissue is not recommended in patients with depressed renal function unless the hypertension is malignant and uncontrolled.
Subject(s)
Hypertension/etiology , Pyelonephritis/complications , Vesico-Ureteral Reflux/complications , Adolescent , Adult , Child , Child, Preschool , Chronic Disease , Female , Humans , Male , Postoperative Complications , Pyelonephritis/etiology , Urinary Tract Infections/complications , Vesico-Ureteral Reflux/surgeryABSTRACT
The diagnosis, treatment and results of 6 patients with 7 obstructed distal ureters secondary to vascular compression are presented. Three ureters were treated by transection of the offending vessels and the remaining 4 required additional ureteroneocystostomy.
