Acute Pyelonephritis

Mostly it results from ascending infection from the bladder.

Clinical Features

• Loin pain: Sudden onset of pain in one or both loins, radiating to the iliac fossae and suprapubic area.

Dysuria and frequent passage of small amounts of scalding cloudy urine due to associated cystitis.

•Fever: 38-40oC

Rigours

vomiting.

Tenderness presenting the renal angle and lumbar region.

Investigations

• ‘ FBE – leucocytosis

• Urine MCS – numerous plus cells and organisms.

• Urine – C/S

. U/S KUB

Complications

• Sepsis and shock

• Emphysematous pyelonephritis by gas-producing organisms.

• Pyonephrosis (abscess formation).

• Chronic pyelonephritis.

Management

-Admit to Hospital

• Antibiotics: – See chart below

• Symptomatic:-  paracetamol for fever