RESUMO
En el estudio de la infección urinaria inicial y recurrente es fundamental el descarte de malformaciones nefrourológicas. Sin embargo, nuevos paradigmas señalan que deben tomarse en cuenta, en especial en las recurrencias, diversos factores de riesgo, tales como, la virulencia bacteriana, patrones de resistencia a antibióticos, alteraciones metabólicas, trastornos de la eliminación, el papel de la inmunidad innata y la respuesta inflamatoria; todo ello puede conllevar a situaciones particulares como bacteriuria asintomática e infecciones urinarias recurrentes. Estos casos ameritan conductas y tratamientos individualizados a cada situación especial
In patients with initial and recurrent urinary tract infection it is essential to exclude nephrourologic malformations. However, new paradigms consider especially recurrences, several risk factors such as bacterial virulence, antibiotic resistance patterns, metabolic disorders, elimination disorders and the role of innate immunity and inflammatory renponse; all of these factors can lead to situations such as asymptomatic bacteriuria and recurrent urinary tract infections. These cases deserve individualized treatment in each unique situation
Assuntos
Infecções Bacterianas , Infecções Urinárias/diagnóstico , Infecções Urinárias/etiologia , NefrologiaRESUMO
We report a case of subcapsular hematoma (SH) of a kidney graft arising during minimal-incision living-donor nephrectomy. SH covered at least two-thirds of the cortical surface. Capsulotomy was not done because it was deemed too risky. In the immediate postoperative period, a rapid deterioration of graft function was observed associated with Doppler sonographic evidence of graft compression. However, in the following days, spontaneous resolution of SH and progressive improvement of Doppler findings was observed, which preceded full recovery of graft function. Conservative management seemed a valid approach of this complication in this case where Doppler sonography proved essential for the follow-up.