Renal confined sarcoidosis: Natural history and diagnostic challenge.
Wikipedia – Most cases of “community-acquired” pyelonephritis are due to bowel organisms that enter the urinary tract. Common organisms are E. coli (70–80%) and Enterococcus faecalis. Hospital-acquired infections may be due to coliform bacteriaand enterococci, as well as other organisms uncommon in the community (e.g., Pseudomonas aeruginosa and various species of Klebsiella). Most cases of pyelonephritis start off as lower urinary tract infections, mainly cystitis and prostatitis.E. coli can invade the superficial umbrella cells of the bladder to form intracellular bacterial communities (IBCs), which can mature into biofilms. These biofilm-producing E. coli are resistant to antibiotic therapy and immune system responses, and present a possible explanation for recurrent urinary tract infections, including pyelonephritis. Risk is increased in the following situations:
- Mechanical: any structural abnormalities in the urinary tract, vesicoureteral reflux (urine from the bladder flowing back into the ureter), kidney stones, urinary tract catheterization, ureteral stents or drainage procedures (e.g., nephrostomy), pregnancy, neurogenic bladder (e.g., due to spinal cord damage, spina bifida or multiple sclerosis) and prostate disease (e.g., benign prostatic hyperplasia) in men
- Constitutional: diabetes mellitus, immunocompromised states
- Behavioral: change in sexual partner within the last year, spermicide use
- Positive family history (close family members with frequent urinary tract infections)
Sarcoidosis – Overview
Sarcoidosis is the growth of tiny collections of inflammatory cells (granulomas) in different parts of your body — most commonly the lungs, lymph nodes, eyes and skin.
Doctors believe sarcoidosis results from the body’s immune system responding to an unknown substance, most likely something inhaled from the air.
There is no cure for sarcoidosis, but most people do very well with little or only modest treatment. In half of cases, sarcoidosis goes away on its own. In a few cases, however, sarcoidosis may last for years and may cause organ damage.
Signs and symptoms of sarcoidosis vary depending on which organs are affected. Sarcoidosis sometimes develops gradually and produces symptoms that last for years. Other times, symptoms appear suddenly and then disappear just as quickly. Many people with sarcoidosis have no symptoms, so the disease may be discovered only when you have a chest X-ray for another reason.
See your doctor if you have signs and symptoms of sarcoidosis.
For many people, sarcoidosis begins with these symptoms:
- Swollen lymph nodes
- Weight loss
Many patients with sarcoidosis experience lung problems, which may include:
- Persistent dry cough
- Shortness of breath
- Chest pain
Some people who have sarcoidosis develop skin problems, which may include:
- A rash of red or reddish-purple bumps, usually located on the shins or ankles, which may be warm and tender to the touch
- Disfiguring sores (lesions) on the nose, cheeks and ears
- Areas of skin that are darker or lighter in color
- Growths under the skin (nodules), particularly around scars or tattoos
Sarcoidosis can affect the eyes without causing any symptoms, so it’s important to have your eyes checked. When eye symptoms do occur, they may include:
- Blurred vision
- Eye pain
- Severe redness
- Sensitivity to light
Signs and symptoms related to cardiac sarcoidosis may include:
- Chest pain
- Shortness of breath (dyspnea)
- Fainting (syncope)
- Irregular heartbeats (arrhythmias)
- Rapid or fluttering heart beat (palpitations)
- Swelling caused by excess fluid (edema)
The symptoms in red have presented.