Respiratory insufficiency associated with pyelonephritis during pregnancy

A previously unreported complication of acute pyelonephritis during pregnancy is described. Acute respiratory distress accompanied by varying manifestations of liver, kidney, hypothalamic, and hematopoietic dysfunction is chronicled in four women. Because these latter organ system effects are attributable to endotoxin, the authors postulate that endotoxin caused alveolar-capillary injury leading to respiratory failure in these pregnant women with acute renal infection.