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Emphysematous pyelonephritis.

Host and bacterial virulence factors each play a role in the pathogenesis of emphysematous pyelonephritis, a study suggests.

Forty-seven patients with the rare but deadly gas-forming infection of the kidney known as emphysematous pyelonephritis (EPN) were compared with 79 patients with non-EPN kidney disease in terms of virulence factors. Diabetes with poor glycemic control was the only host factor independently associated with EPN (odds ratio 4.9), but urinary tract obstruction with impaired renal circulation also was more prevalent in EPN patients (32% vs. 11%), reported Chin-Chung Tseng, M.D., and colleagues at the National Cheng Kung University, Tainan, Taiwan (Am. J. Kidney Dis. 2005;46:432-9).

Furthermore, in causative strains of Escherichia coli (the causative agent in 16 of 47 of the EPN cases, and in 60%-70% of cases in general), the papG II adhesin gene was identified significantly less often than in non-EPN E. coli strains (odds ratio 0.2), and the genetic determinant of uropathogenic-specific protein was identified more often in causative strains than in non-EPN E. coli strains, the investigators found.
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Title Annotation:CLINICAL CAPSULES
Author:Worcester, Sharon
Publication:Internal Medicine News
Article Type:Brief Article
Geographic Code:1USA
Date:Oct 15, 2005
Words:176
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