Pyelonephritis

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Pyelonephritis


  • infection in kidney
  • acute leads to pus and abscess formation
  • chronically leads to scarring and contraction
  • infection may be via reflux of infected urine or from blood

Presentation

  • fever
  • rigors / chills
  • loin pain
  • flank pain
  • pyuria
  • bacteruria.

Causes

  • urinary tract obstruction
    • stone
    • tumour
    • abnormal peristalsis
  • reflux
    • congenital
    • pregnancy
  • haematogenous spread

Treatment

  • broad-spectrum intravenous antibiotics until urine and blood culture available
  • 14-day treatment is recommended (21 days if known anatomic or functional abnormalities)

Non-responders / deterioration

  • upper tract imaging
 

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