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Infections of the urinary tract are protean in their clinical manifestations, pathogenesis, and pathologic importance as well as in bacterial etiology. A few reports differentiating chronic pyelonephritis from Bright's disease * appeared in the literature prior to 1939, but, in general, until recently, clinical infections of the urinary tract were classified according to the anatomic part believed to be the site of the infection. Thus, urethritis, cystitis, pyelitis, and pyelonephritis, at least, were regarded as separate entities. The classic publication of Weiss and Parker,4in 1939, and others since that time, altered this point of view and indicated a tendency for infection to involve the entire urinary tract regardless of the site of origin of the infection. Weiss and Parker4classified pyelonephritis according to morphologic changes in the kidney into acute, chronic, healed, and healed and recurrent stages. Clinical recognition of acute pyelonephritis is not difficult, but patients with
Gilbert P. Kipnis (1955) studied this question.