Pyelonephrit

is

Pyelonephritis: Definition:
Is a bacterial infection causing
inflammation of the renal pelvis,
tubules, and interstitial tissue of
one or both kidneys.

Pyelonephritis: Causes:

1. Common cause is the infection of the bacteria E. coli

2. May also be caused by candidiasis.
3. May be acute:

Usually enlarged kidney, maybe abscesses, and

possibly destruction of glomeruli.
4.

May be chronic:

Kidneys scarred, contracted, & nonfunctioning

mechanisms
of
bacterial
infection
in
pyelonephriti
s

Causes incidence, and

risk
factors
The risk is increased if there is a history
of :
cystitis.
renal papillary necrosis.
kidney stones.
vesicoureteric reflux or obstructive uropathy.

Acute pyelonephritis can be severe in

the elderly and in people who are
immunosuppressed (for example, those
with cancer or AIDS).

Pyelonephritis: Classification:

1. Acute
uncomplicated
pyelonephritis.
2. Chronic pyelonephritis

Pyelonephritis: Differences and similarities :

Inflammatory disorder
Renal tubules, interstitium, calcyces,
and pelvis
Infection may be present
Combination of Chronic TIN,
infection, stasis, obstruction, stone
formation

Acute

Acute pyelonephritis
Acute pyogenic infection of kidney
Usually E. Coli and other fecal flora

Chronic

Chronic pyelonephritis
Persistent or recurring episodes of
acute pyelonephritis that lead to
scarring
Reflux nephropathy (most frequent Figure from: Huether, Understanding Pathophysiology, 5

th

Elsevier, 2012

ed.,

Pyelonephritis:Symptoms:
1.
2.
3.
4.
5.
6.
7.
8.

9.

Flank pain or back pain.

Severe abdominal pain
high fever and persists for more than 2
days.
Chills with shaking.bWarm, flushed,
moist skin.
Vomiting, nausea.
Fatigue and general ill feeling.
Painful urination, urinary frequency or
urgency nocturia.,
Cloudy or abnormal urine color, foul or
strong urine odor, and hematuria may
occur.
Mental changes of confusion

Diagnostic studies
A urinalysis commonly
reveals white blood cells
(WBCs) or red blood cells
(RBCs).
A urine culture may reveal
bacteria in the urine.
A blood culture may show an
infection.
An intravenous pyelogram
(IVP) or CT scan of the
abdomen may show
enlarged kidneys with poor
flow of dye through the
kidneys.

Treatment
The goals of treatment are
control of the infection and
reduction of symptoms.
Acute symptoms usually
resolve within 48 to 72 after
appropriate treatment.
Intravenous (IV) antibiotics
may be used initially to
control the bacterial infection
if infection is severe a 10- to
14 day course of antibiotics
chronic pyelonephritis.

Antibiotic therapy
Antibiotics used
in the treatment
of
pyelonephritis:
Ciprofloxacin 500
mg every 12 hours
for 14 days.

Complications:

Recurrence of pyelonephritis.
Perinephric abscess (infection
around the kidney).
Sepsis .
Acute renal failure.
Chronic renal failure.