The Ultrastructure of Acute Pyelonephritis in the Monkey

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Abstract
P-fimbriated Escherichia coli, which have specific receptors on urothelial cells for their fimbriae, were used to produce pyelonephritis [Macaca fascicularis, M. mulatta and Papio papio]. Using both scanning and electron microscopy, it was shown that the bacteria attached to ureteral epithelium by 12 h after inoculation. They developed into a biolayer of bacteria covering the epithelium by 48 h, but did not invade within that time. In the kidney, adherence was seen by 6 h in collecting proximal and distal tubules. While many bacteria were seen, tubular epithelium remained normal through 24 h. The inflammatory response was first seen at 48 h. Phagocytosis was accompanied by mortal damage to both phagocytes and surrounding tubules. This was followed by bacterial invasion of the interstitium.