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PYELONEPHRITIS, ACUTE

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CONDITION/DISORDER SYNONYM

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  • Kidney Infection

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ICD-9-CM CODE

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  • 590.9 Infection of kidney, unspecified

  • Associated physical therapy diagnoses

    • 315.4 Developmental coordination disorder (clumsiness, dyspraxia and/or specific motor development disorder)

    • 718.45 Contracture of joint, pelvic region and thigh

    • 719.70 Difficulty in walking

    • 728.2 Muscular wasting and disuse atrophy

    • 728.89 Other disorders of muscle, ligament, and fascia

    • 729.9 Other disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 781.2 Abnormality of gait

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

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ICD-10-CM CODE

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  • N15.9 Renal tubulo-interstitial disease, unspecified

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PREFERRED PRACTICE PATTERN1

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As of July, 2014, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology; therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.

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FIGURE 59-1

Plain films of the abdomen with abnormal radiolucencies. (A) Emphysematous pyelonephritis. Interstitial striated pattern of radiolucent gas throughout the entire left kidney. Similar changes were present in the right kidney. 58-year-old diabetic man with pyuria and septic shock. (B) Gas pyelogram. No interstitial gas, but gas fills dilated left kidney calices, pelvis, and ureter. 50-year-old diabetic woman with sepsis and left upper urinary tract infection caused by gas-forming microorganisms. (From Tanagho EA, McAninch JW. Smith’s General Urology. 17th ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
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FIGURE 59-2

Approach to the patient with urine culture, urine dipstick, or urine microscopy suggestive of urinary tract infection (UTI). (From McKean S, Ross JJ, Dressler DD, Brotman DJ, Ginsberg JS. Principles and Practice of Hospital Medicine. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
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PATIENT PRESENTATION

Patient is a 38-year-old female that presents with low back and groin pain. She states it has been bothering her for 2 days. The patient has a fever of 100.4°F. The patient also states she has had a urinary tract infection (UTI) that has not gone away. The low back and groin pain are not reproducible. She has negative slump and SLR test. She does have lumbar spasms. The patient was referred to her family physician. The patient was sent to the hospital 2 days later with increased fever and decreased kidney functioning.

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KEY FEATURES
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Description
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  • Bacteria build up in the kidneys

  • Usually begins in the bladder and works up to the kidneys

  • Kidney and renal pelvis infection

  • Severe pain, with or without attempts at urination, in adult males and females; no pain at all, especially in the elderly and children

  • Pain in the low back with possible tenderness to ...

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