Pyelonephritis

Pyelonephritis is a type of urinary tract infection (UTI) that affects the kidneys. It is an inflammation of the kidney, specifically the renal pelvis and parenchyma, which can be caused by bacterial or fungal infections.

Causes and Risk Factors

The most common cause of pyelonephritis is a bacterial infection, typically Escherichia coli (E. coli), Klebsiella pneumoniae, Pseudomonas aeruginosa, or Enterococcus faecalis. The bacteria usually enter the kidneys through the ureters, which connect the kidneys to the bladder. Risk factors for developing pyelonephritis include:

• Female sex
• Pregnancy
• Diabetes
• Obstruction of the urinary tract, such as kidney stones or tumors
• Weakened immune system
• Neurogenic bladder
• Catheter use

Symptoms

The symptoms of pyelonephritis can vary in severity and may include:

• Fever and chills
• Flank pain or tenderness, usually on one side
• Nausea and vomiting
• Abdominal pain
• Urinary frequency or urgency
• Burning sensation while urinating
• Cloudy or foul-smelling urine
• Blood in the urine (hematuria)

Diagnosis

The diagnosis of pyelonephritis is typically made based on a combination of:

• Medical history and physical examination
• Urinalysis, which may show the presence of bacteria, white blood cells, or red blood cells in the urine
• Urine culture, which can identify the specific type of bacteria causing the infection
• Blood tests, such as a complete blood count (CBC) and blood cultures
• Imaging studies, such as ultrasound or computed tomography (CT) scans, to evaluate the kidneys and urinary tract for any obstructions or abnormalities

Treatment

The treatment of pyelonephritis typically involves:

• Antibiotics, which are usually prescribed for 10-14 days
• Pain management with analgesics, such as acetaminophen or ibuprofen
• Fluid replacement to prevent dehydration
• Rest and avoiding strenuous activities
• In severe cases, hospitalization may be necessary for intravenous antibiotics and close monitoring

Complications

If left untreated or inadequately treated, pyelonephritis can lead to complications such as:

• Sepsis, a life-threatening condition that occurs when the infection spreads to the bloodstream
• Kidney damage or scarring
• Recurrent UTIs
• Pregnancy complications, such as preterm labor or low birth weight

Prevention

To reduce the risk of developing pyelonephritis, it is recommended to:

• Practice good hygiene, such as wiping from front to back after using the bathroom
• Urinate when needed and avoid holding urine for long periods
• Stay hydrated by drinking plenty of water
• Avoid using catheters or other urinary devices unless necessary
• Manage underlying medical conditions, such as diabetes or neurogenic bladder