Pyelonephritis


Pyelonephritis

Description, Causes and Risk Factors:

ICD-10: N11.9

Inflammation of the renal parenchyma, calices, and pelvis, particularly due to local bacterial infection.

Your kidneys 'clean' your blood by filtering out water and waste products to make urine. The urine is stored in your bladder and then passed out of your body through your urethra.

Pyelonephritis is a bacterial infection of the kidney. It can be serious because of the important function of the kidneys and because the infection may enter the bloodstream. It can also cause pregnant women to go into labor too early (premature labor). Kidney infections are much more common in women than men. Infection of the kidney is more serious than a bladder infection or lower urinary tract infection. About 1 out of 7,000 people develop pyelonephritis each year in the US..

Major Types:

    Acute uncomplicated pyelonephritis is the sudden development of kidney inflammation.

  • Chronic pyelonephritis is a long-standing infection that does not go away.

Infections of the kidneys normally occur because bacteria enter the urinary tract through the urethra and start to multiply. Bacteria from an infection in some other area of the body can spread through the blood system to the kidneys. Infections of the kidney is not normally because of this route to the kidneys but it often can occur in this method - for instance; when some foreign body, such as an joint that is artificial or heart valve gets infected. Very rarely, infections of the kidneys results after some sort of surgery on the kidneys.

Risk factors for pyelonephritis include:

    Birth defect involving the genitourinary system (kidneys, bladder, ureters)

  • Cystocele.

  • Diabetes.

  • Elderly.

  • Enlarged prostate.

  • Female gender.

  • Kidney stones.

  • Prostatitis.

  • Spinal cord injury.

  • Urinary catheter.

  • Urinary tract surgery.

Symptoms:

The symptoms range from mild to severe. They may include:

    Pyelonephritis presents with dysuria (painful voiding of urine).

  • In many cases there are systemic symptoms in the form of fever, rigors (violent shivering while the temperature rises), headache, and vomiting.

  • Abdominal or back pain.

  • Loss of appetite.

  • Nausea or vomiting.

  • Problems with urination, such as pain when you urinate or having a frequent urge to urinate.

Skin changes:

  • Flushed or reddened skin.

  • Moist skin (diaphoresis).

  • Warm skin.

Urination problems:

  • Blood in the urine.

  • Cloudy or abnormal urine color.

  • Foul or strong urine odor.

  • Increased urinary frequency or urgency.

  • Need to urinate at night (nocturia).

  • Painful urination.

Diagnosis:

A physical exam may show tenderness when the health care provider presses (palpates) the area of the kidney.

    Blood culture may show an infection.

  • Urinalysis commonly reveals white or red blood cells in the urine.

  • Other urine tests may show bacteria in the urine.

  • An intravenous pyelogram (IVP) or CT scan of the abdomen may show swollen kidneys. These tests can also help rule out underlying disorders.

Additional tests and procedures that may be done include:

    Kidney biopsy.

  • Kidney scan.

  • Kidney ultrasound.

  • Voiding cystourethrogram.

Treatment:

Drink enough fluids to stop dehydration; this is particularly important in pregnant women and people over 65.

Antibiotic medicine is the main treatment for a kidney infection. Your health care provider may treat you first as an outpatient. You may continue to be treated at home if your symptoms appear to be getting better 24 hours after you start taking the antibiotic. If you are more seriously ill or dehydrated, or the antibiotic does not seem to be working well, you may need to stay in the hospital. There you can be given fluids and medicine with an IV.

You will need to take antibiotics for at least 10 days. All bacteria must be killed to prevent kidney damage and to keep the infection from coming back.

Your antibiotic may need to be changed after the first day or two of treatment if lab tests of the bacteria in your urine show a different antibiotic will work better. Your health care provider will call you if this is the case.

Commonly used antibiotics may include the following:

    Amoxicillin.

  • Cephalosporin.

  • Levofloxacin and ciprofloxacin.

  • Sulfa drugs such as sulfisoxazole/trimethoprim.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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