Editing Excretory system (section)

=== Pyelonephritis ===
{{Main|Pyelonephritis}}

[[Pyelonephritis]] is a type of [[urinary tract infection]] that occurs when bacteria enters the body through the urinary tract. It causes an inflammation of the renal parenchyma, calyces, and pelvis.<ref>{{Cite web|url=http://www.medilexicon.com/dictionary/74282|title=mediLexicon|website=mediLexicon}}</ref> There are three main classifications of pyelonephritis: acute, chronic and [[Xanthogranulomatous inflammation|xanthogranulomatous]].

==== Acute pyelonephritis ====
In acute pyelonephritis, the patient experiences high fever, abdominal pain and pain while passing urine. Treatment for acute pyelonephritis is provided via antibiotics and an extensive urological investigation is conducted to find any abnormalities and prevent recurrence.<ref>{{Cite book|title=Concise Medical Dictionary (9 ed.)|last=Martin|first=Elizabeth|publisher=Oxford University Press|year=2015|isbn=978-0-19-968781-7}}</ref>

==== Chronic pyelonephritis ====
In chronic pyelonephritis, patients experience persistent abdominal and flank pain, high fever, decreased appetite, weight loss, urinary tract symptoms and blood in the urine. Chronic pyelonephritis can also lead to scarring of the renal parenchyma caused by recurrent kidney infections.<ref name=":0">{{cite journal |last1=Korkes |first1=Fernando |last2=Favoretto |first2=Ricardo L. |last3=Bróglio |first3=Marcos |last4=Silva |first4=Carlos A. |last5=Castro |first5=Marilia G. |last6=Perez |first6=Marjo D.C. |title=Xanthogranulomatous Pyelonephritis: Clinical Experience with 41 Cases |journal=Urology |date=February 2008 |volume=71 |issue=2 |pages=178–180 |doi=10.1016/j.urology.2007.09.026 |pmid=18308077 }}</ref>

==== Xanthogranulomatous pyelonephritis ====
Xanthogranulomatous pyelonephritis is an unusual form of chronic pyelonephritis. It results in severe destruction of the kidney and causes granulomatous abscess formation. Patients infected with Xanthogranulomatous pyelonephritis experience recurrent fevers, [[anemia]], kidney stones and loss of function in the affected kidney.<ref name=":0" />

==== Treatment ====
A urine culture and antibiotics sensitivity test is issued for patients who are believed to have pyelonephritis. Since most cases of pyelonephritis are caused from bacterial infections, antibiotics are a common treatment option. Depending on the species of the infecting organism and the antibiotics sensitivity profile of the organism, treatments may include [[Quinolone antibiotic|fluoroquinolones]], [[cephalosporin]]s, [[aminoglycoside]]s, or [[trimethoprim]] individually or in combination.<ref>{{cite journal |last1=Gupta |first1=Kalpana |last2=Hooton |first2=Thomas M. |last3=Naber |first3=Kurt G. |last4=Wullt |first4=Björn |last5=Colgan |first5=Richard |last6=Miller |first6=Loren G. |last7=Moran |first7=Gregory J. |last8=Nicolle |first8=Lindsay E. |last9=Raz |first9=Raul |last10=Schaeffer |first10=Anthony J. |last11=Soper |first11=David E. |last12=Infectious Diseases Society of |first12=America |last13=European Society for Microbiology and Infectious |first13=Diseases |title=International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases |journal=Clinical Infectious Diseases |date=1 March 2011 |volume=52 |issue=5 |pages=e103–e120 |doi=10.1093/cid/ciq257 |pmid=21292654 |doi-access=free }}</ref> For patients with xanthogranulomatous pyelonephritis, treatment might include antibiotics as well as surgery. [[Nephrectomy]] is the most common surgical treatment for a majority of cases involving xanthogranulomatous pyelonephritis.<ref name=":0"/>

==== Epidemiology ====
In men, roughly 2-3 cases per 10,000 are treated as outpatients and 1 in 10,000 cases require admission to the hospital. In women, approximately 12–13 in 10,000 cases are treated as outpatients and 3-4 cases are admitted to a hospital.<ref>{{cite journal |last1=Czaja |first1=C. A. |last2=Scholes |first2=D. |last3=Hooton |first3=T. M. |last4=Stamm |first4=W. E. |title=Population-Based Epidemiologic Analysis of Acute Pyelonephritis |journal=Clinical Infectious Diseases |date=August 2007 |volume=45 |issue=3 |pages=273–280 |doi=10.1086/519268 |pmid=17599303 |doi-access=free }}</ref> The most common age group affected by Xanthogranulomatous pyelonephritis is middle-aged women.<ref>{{cite journal |last1=Malek |first1=Reza S. |last2=Elder |first2=Jack S. |title=Xanthogranulomatous Pyelonephritis: A Critical Analysis of 26 Cases and of the Literature |journal=Journal of Urology |date=May 1978 |volume=119 |issue=5 |pages=589–593 |doi=10.1016/s0022-5347(17)57559-x |pmid=660725 }}</ref> Infants and elderly are also at an increased risk because of hormonal and anatomical changes.<ref>{{cite journal |last1=Goodman |first1=Tr |last2=McHugh |first2=K |last3=Lindsell |first3=M |title=Paediatric xanthogranulomatous pyelonephritis |journal=International Journal of Clinical Practice |date=January 1998 |volume=52 |issue=1 |pages=43–45 |doi=10.1111/j.1742-1241.1998.tb11558.x |pmid=9536568 }}</ref>