Summary about Disease
Pyelonephritis is a type of urinary tract infection (UTI) that specifically affects one or both kidneys. It's a serious infection that needs prompt medical treatment to prevent kidney damage and other complications. It occurs when bacteria, usually from the lower urinary tract (bladder and urethra), travel up to the kidneys.
Symptoms
Symptoms of pyelonephritis can vary in severity and may include:
Fever
Chills
Back, side (flank), or groin pain
Abdominal pain
Nausea
Vomiting
Frequent urination
Urgent need to urinate
Painful urination (dysuria)
Pus or blood in the urine (hematuria)
Cloudy urine
Foul-smelling urine
Causes
The most common cause of pyelonephritis is a bacterial infection, often Escherichia coli (E. coli), which is normally found in the digestive tract. Other bacteria can also cause the infection. Bacteria can enter the kidneys from:
An existing UTI that spreads upwards from the bladder.
Bacteria traveling through the bloodstream to the kidneys (less common).
Blockages in the urinary tract, such as kidney stones or an enlarged prostate.
Vesicoureteral reflux (VUR), a condition where urine flows backward from the bladder to the ureters and kidneys.
Medicine Used
Treatment for pyelonephritis typically involves antibiotics. The specific antibiotic prescribed will depend on the type of bacteria causing the infection and its antibiotic sensitivities. Common antibiotics used include:
Fluoroquinolones (e.g., ciprofloxacin, levofloxacin)
Cephalosporins (e.g., ceftriaxone)
Aminoglycosides (e.g., gentamicin)
Trimethoprim/sulfamethoxazole (Bactrim) Severe cases may require hospitalization and intravenous (IV) antibiotics. Pain relievers may also be prescribed to manage pain and fever.
Is Communicable
Pyelonephritis itself is not communicable or contagious. It's an infection caused by bacteria, usually originating from the person's own body (e.g., E. coli from the digestive tract). It's not spread from person to person.
Precautions
To help prevent pyelonephritis and UTIs in general, consider these precautions:
Drink plenty of fluids to flush bacteria from the urinary tract.
Urinate when you feel the urge; don't hold it in.
Wipe from front to back after using the toilet.
Urinate after sexual activity.
Avoid using irritating feminine products, such as douches and deodorant sprays.
If prone to UTIs, talk to your doctor about preventive measures like low-dose antibiotics or cranberry products.
Manage any underlying conditions that may increase your risk, such as diabetes or kidney stones.
How long does an outbreak last?
With prompt antibiotic treatment, symptoms of pyelonephritis typically start to improve within 24 to 72 hours. A full course of antibiotics is usually prescribed for 10-14 days, and it's important to complete the entire course, even if you feel better, to ensure the infection is completely eradicated and to prevent antibiotic resistance.
How is it diagnosed?
Pyelonephritis is usually diagnosed based on a combination of factors:
Medical History and Physical Exam: The doctor will ask about your symptoms and medical history.
Urine Tests: A urine sample is analyzed to check for bacteria, white blood cells, and red blood cells. A urine culture can identify the specific type of bacteria causing the infection and determine which antibiotics will be most effective.
Blood Tests: Blood tests may be done to check for signs of infection, such as an elevated white blood cell count.
Imaging Tests: In some cases, imaging tests like a CT scan or ultrasound may be used to look for kidney stones, blockages, or other abnormalities that could be contributing to the infection, especially if the infection doesn't respond to treatment.
Timeline of Symptoms
The timeline of symptoms can vary, but a general progression might look like this:
Initial Phase (1-2 days): Symptoms may start with lower urinary tract symptoms like frequent urination, painful urination, and urgency. Fever and chills may begin during this phase.
Progression (2-3 days): Symptoms worsen, including flank pain, abdominal pain, nausea, vomiting, and high fever.
Treatment (within 24-72 hours of starting antibiotics): Improvement in symptoms starts to occur with appropriate antibiotic treatment. Fever should start to subside, and pain should lessen.
Recovery (10-14 days): Completing the full course of antibiotics is crucial for complete eradication of the infection and prevention of recurrence. Some residual symptoms like fatigue may linger for a few days after finishing the medication.
Important Considerations
Seek Prompt Medical Attention: Pyelonephritis is a serious infection that requires immediate medical attention. Delaying treatment can lead to severe complications, including kidney damage, sepsis (a life-threatening blood infection), and kidney abscesses.
Complete the Full Course of Antibiotics: It's crucial to finish the entire course of antibiotics prescribed by your doctor, even if you start feeling better. Stopping early can lead to recurrence of the infection or the development of antibiotic-resistant bacteria.
Follow-Up Care: After treatment, your doctor may recommend a follow-up urine culture to ensure the infection has been completely eradicated.
Underlying Conditions: If you have recurrent UTIs or pyelonephritis, your doctor may investigate underlying conditions that may be contributing to the problem, such as kidney stones, structural abnormalities of the urinary tract, or vesicoureteral reflux.
Pregnancy: Pyelonephritis during pregnancy can be particularly dangerous and requires prompt treatment to protect both the mother and the baby.