What is Pyelonephritis?

Pyelonephritis is an infection of the kidneys and it usually occurs when a urinary tract infection ascends to the kidneys. Pyelonephritis can be divided into complicated and uncomplicated pyelonephritis. Complicated diseases are seen in pregnant women, chronic kidney disease, uncontrolled diabetics, and patients with urinary anatomical abnormalities. The main risk factors for getting pyelonephritis is being a female, having a urinary blockage which slows the ability to empty the bladder and having a urinary catheter. E. coli is the most common pathogen that causes acute pyelonephritis. 

What are the symptoms of Pyelonephritis?

  • Fever
  • Plank pain
  • Nausea 
  • Vomiting
  • Burning on urination
  • Urinary urgency
  • Urinary frequency
  • Pus or blood in the urine

What are the complications of Pyelonephritis?

Complications start appearing when the condition goes untreated for a long time. Most common complications are the following: 

  • Septicemia: since the function of the kidneys to filter wastes from the blood and return the filtered blood to the rest of the body, when there is a kidney infection, the bacteria can be spread throughout the body by the bloodstream.
  • Kidney scarring: due to the infection and inflammation, the kidneys start scaring which creates kidney damage. 

How is Pyelonephritis diagnosed?

A physical examination along with your signs and symptoms help the diagnosis of this condition. A urine sample will show if there is bacteria on your urine and will also show if there is any blood or pus present. Blood test such as a complete blood cell count is obtained to check for any elevation of white cell count which indicates an infection. Imaging studies are not necessary for the diagnosis of pyelonephritis but tests such as ultrasound can reveal any anatomical abnormalities that can be causing the condition. 

How is Pyelonephritis treated?

The treatment of pyelonephritis is mainly antibiotics. What antibiotic to use may vary depending on what kind of bacteria is causing the condition and this can be revealed by a urine culture.  Complicated pyelonephritis patients should be managed inpatients since the disease could advance quickly. Uncomplicated can be managed at home with antibiotics. If the condition is caused by an anatomical defect this should be corrected with surgery. The best prevention for pyelonephritis is to drink a lot of fluids, urinate when you need to and try not to hold it, wipe carefully and women should wipe from front to back and emptying your bladder after intercourse. 

What are the differential diagnoses of Pyelonephritis?

  • Appendicitis
  • Nephrolithiasis
  • Pelvic inflammatory disease
  • cholecystitis

For more information about the diagnosis and treatment of pyelonephritis please click here.

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