Abstract
Three cases of calculus-related pyelonephritis in the elderly were reported. In addition to the administration of antibiotics and fluid intake to promote diuresis, a citrate acid preparation was administered (conservative treatment). The first case had an episode of mild left pyelonephritis. Ten months later, left obstructive pyelonephritis recurred due to the descent of a kidney stone. After one week of conservative treatment, non-enhanced CT showed the stone collapsed and decreased in size. Four weeks later, stones were excreted completely. The second case developed obstructive pyelonephritis due to a right upper ureteral stone and infectious debris in the renal pelvis. After two weeks of conservative treatment, non-enhanced CT showed the return of the stone into the renal pelvis and disappearance of debris. Six months later, the stone was excreted spontaneously. The third case developed obstructive pyelonephritis due to a lower left ureter stone. Small stones were also detected in both kidneys. After one week of conservative treatment, non-enhanced CT revealed ureteral stones descended into the bladder. three months after, excretion of the left kidney stones and bladder stone were noted, whereas small right kidney stones remained.
Conservative treatment may be a suitable therapeutic approach for elderly patients for whom spontaneous stone excretion is expected.
