Clinical Characteristics of Acute Pyelonephritis in Adult Men

Lee, Ji Hyun; Huh, Jung Sik; Kim, Young Joo

Abstract

PURPOSE: The clinical features, cause and complications of acute pyelonephritis (APN) in adult males are unknown. Moreover, complicated APN has a more severe course and additional procedures than simple APN. Therefore, the current clinical characteristics of adult male APN were studied.
MATERIALS AND METHODS
We analysed the clinical features, cause, causative microorganism and urologic procedure for the treatment of 74 patients diagnosed with APN for 10 years.
RESULTS
The peak age of the adult male patients was over sixty (36.5%). The major symptoms and sign was costovertebral angle (CVA) tenderness (100%). The rate of male complicated APN patients was 62.2% of the total male APN patients; their major causes were urinary tract stone disease (17.6%), neurogenic bladder (12.2%) and benign prostatic hyperplasia (9.5%). The periods of flank pain and of costovertebral angle tenderness were significant differentiated between the complicated and uncomplicated groups. The positive culture rate was 41.9%, and the most common microorganism was E. coli (21.6%). Additional urologic procedures were needed in 33 cases, including clean intermittent catheterization (CIC) (33.2%), extracorporeal shock wave lithotripsy (ESWL) (30.2%) and alpha-blocker medication (21.1%).
CONCLUSIONS
The APN in adult male patients was commonly complicated APN, and most needed an additional urologic procedure. Therefore, the concern of the urologists is required.