acute pyelonephritis

Acute Pyelonephritis: A Sudden and Severe Kidney Infection

Acute pyelonephritis is a sudden and severe kidney infection that can cause permanent damage if left untreated. It is a type of urinary tract infection (UTI) that usually moves from the bladder to the kidneys, causing inflammation and swelling in the affected area.

Symptoms of Acute Pyelonephritis

The symptoms of acute pyelonephritis typically include:

• Fever
• Chills
• Severe back or flank pain
• Nausea and vomiting
• Costovertebral angle tenderness (pain when pressing on the lower back)
• Frequent, painful urination
• Back, side (under the ribs), and groin pain

Causes of Acute Pyelonephritis

Acute pyelonephritis is usually caused by a bacterial infection, most often Escherichia coli. The bacteria can ascend from the lower urinary tract to the kidneys or reach the kidney via the bloodstream.

Complications of Untreated Acute Pyelonephritis

If left untreated, acute pyelonephritis can lead to serious complications, including:

• Permanent damage to the kidneys
• Scarring of the kidney
• Organ- and/or life-threatening infections

Treatment of Acute Pyelonephritis

Acute pyelonephritis is typically treated with antibiotics. It is essential to seek medical attention immediately if symptoms persist or worsen over time.

References:

[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13]

Common Signs and Symptoms of Acute Pyelonephritis

Acute pyelonephritis, a type of kidney infection, can manifest in various ways. The symptoms can range from mild to severe and may vary depending on age.

• Fever: A high temperature is often the first sign of acute pyelonephritis [1].
• Pain: Pain in the back, side (under the ribs), or groin area is a common symptom [3][4]. The pain can be severe and may radiate to other areas.
• Urinary Symptoms: Frequent, painful urination; cloudy or smelly urine; and blood or pus in the urine are also symptoms of acute pyelonephritis [4].
• Nausea and Vomiting: Many people experience nausea and vomiting due to the infection [2][5].
• Chills: Chills can occur, especially in adults [5].
• General Aching: A general feeling of being unwell or having aches and pains is also common [7].

Age-Specific Symptoms

The symptoms of acute pyelonephritis can vary depending on age:

• Newborns: May have poor feeding and vomiting, but no fever.
• Children under 2: May have a fever (but not always), poor appetite, and vomiting.
• Adults: Commonly present with acute-onset fever, chills, severe back or flank pain, nausea and vomiting [5].

It's essential to seek medical attention if you experience any of these symptoms. Prompt treatment can help alleviate the discomfort and prevent complications.

References: [1] - Symptoms include fever, trouble peeing, lower back pain and pain when you pee. [2] - Feb 28, 2024 — Nausea and/or vomiting - These vary in frequency and intensity, from absent to severe; anorexia is common in patients with acute pyelonephritis. [3] - Aug 6, 2022 — Back, side or groin pain; Nausea and vomiting; Pus or blood in the urine; Urine that smells bad or is cloudy; Belly pain. When to see a doctor. [4] - Symptoms. Symptoms or signs may include: Frequent, painful urination; Back, side (under the ribs), and groin pain; Chills and high fever; Nausea and vomiting. [5] - Oct 1, 2024 — Acute pyelonephritis in adults commonly presents as acute-onset fever, chills, severe back or flank pain, nausea and vomiting, ... [6] - Signs and symptoms vary with age: Newborns: no fever but poor feeding and vomiting; Children <2: may have a fever (but not always), a poor appetite, vomiting ... [7] - What are the symptoms? · shaking or chills · nausea · vomiting · general aching or ill feeling · fatigue · moist skin · mental confusion.

Diagnostic Tests for Acute Pyelonephritis

Acute pyelonephritis, a bacterial infection of the kidney and renal pelvis, requires prompt diagnosis to initiate effective treatment. The following diagnostic tests are commonly used to confirm the presence of this condition:

• Imaging tests: Computed Tomography (CT) scans, Magnetic Resonance Imaging (MRI), or ultrasound may be performed to visualize the kidneys and detect any abnormalities.
• Urinalysis: A urine sample is analyzed for signs of infection, such as bacteria, blood, or pus. This test helps confirm the diagnosis of pyelonephritis.
• Urine culture: A urine sample is cultured to identify the type of bacteria causing the infection and determine its antimicrobial susceptibility.
• Blood tests: Blood samples may be taken to check for signs of infection, such as elevated white blood cell count or presence of bacteria in the blood.

Additional Diagnostic Tests

In some cases, additional diagnostic tests may be performed to confirm the diagnosis of acute pyelonephritis. These include:

• Retrograde pyelography: A radiologic procedure that involves injecting a contrast agent into the kidneys to visualize any abnormalities.
• CT scan or renal ultrasound: Imaging tests that can help detect complications or underlying conditions contributing to the infection.

Key Points

• Urinalysis and urine culture are essential diagnostic tests for confirming acute pyelonephritis.
• Imaging tests, such as CT scans or ultrasounds, may be performed to visualize the kidneys and detect any abnormalities.
• Blood tests may be taken to check for signs of infection.
• Additional diagnostic tests, such as retrograde pyelography, may be performed in some cases.

References

[1] (Context 10) Acute pyelonephritis is a bacterial infection causing renal inflammation and is one of the most common kidney diseases. [2] (Context 12) Urinalysis and urine culture confirm the diagnosis of acute pyelonephritis. [3] (Context 13) Imaging, such as CT scans or ultrasounds, may be performed to identify complications or underlying conditions contributing to the infection. [4] (Context 14) Though guidelines state that imaging is inappropriate in most patients with pyelonephritis, it is nevertheless often done for diagnosis or identification of complications.

Treatment Options for Acute Pyelonephritis

Acute pyelonephritis, a bacterial infection of the kidney and renal pelvis, requires prompt treatment to prevent complications and promote recovery. The primary goal of treatment is to eliminate the infection with antibiotics.

• Antibiotic Therapy: Fluoroquinolones (FQ) are often considered the first-line empiric treatment for acute pyelonephritis [1]. Gentamicin can also be used, especially when given intravenously or as a single dose in outpatient treatment [4].
• Duration and Route of Administration: The optimal duration and route of antibiotic administration vary. Some studies suggest that long-course antibiotics may be more effective than short-course regimens [5].
• Complicated Cases: In cases where the infection is complicated, such as emphysematous pyelonephritis, treatment may involve intravenous hydration and antibiotics for 24 to 48 hours [7].

Multidisciplinary Approach

Treatment of acute pyelonephritis often requires a team effort involving various healthcare professionals, including primary care providers, emergency room specialists, nephrologists, infectious disease consultants, pain specialists, internists, urologists, and obstetricians if the patient is pregnant [10].

Key Takeaways

• Fluoroquinolones are commonly used as first-line treatment for acute pyelonephritis.
• Gentamicin can be effective when given intravenously or as a single dose in outpatient treatment.
• The optimal duration and route of antibiotic administration may vary depending on the individual case.
• A multidisciplinary approach is often necessary to ensure proper treatment and management.

References:

[1] Context result 3: Patients hospitalized with acute pyelonephritis should be treated with one of three initial intravenous therapies: a fluoroquinolone; an ...

[4] Context result 4: Fluoroquinolones (FQ) are the first line of empiric treatment for acute pyelonephritis. Gentamicin. An effective modality when given IV or IM or as a first dose in outpatient treatment.

[5] Context result 5: Though antibiotics are the cornerstone for the treatment of acute pyelonephritis, the optimal drug, duration, and route of administration are still varied .

[7] Context result 7: Treatment may include intravenous hydration and antibiotics for 24 to 48 hours.

[10] Context result 10: The treatment of acute pyelonephritis is best addressed by a team of healthcare professionals, including primary care providers, emergency room specialists, a nephrologist, an infectious disease consultant, a pain specialist, an internist, a urologist, or an obstetrician if the patient is pregnant.