Urographic and Angiographic Abnormalities in Adult-Onset Acute Bacterial Nephritis

Five cases of a severe form of acute bacterial renal infection are presented. Urographic findings included enlargement of the renal outline and marked decrease of nephrographic density on the involved side. In 3 patients no calyceal opacification occurred due to the severe impairment of contrast agent excretion (retrograde pyelography excluded obstruction). Fine linear stripes thought to represent occlusive or vasoreactive changes at the level of the interlobular artery or afferent arteriole were seen at angiography. There was acute interstitial inflammatory infiltrate in 2 resected kidneys. Three patients treated with antibiotics returned toward normal within 25 days of the initial urographic examination.