Acute Pyelonephritis - How To Diagnose It?

The kidneys are the main part of the urinary system, which also includes the bladder, the ureter, and the urethra. Infections reach the urinary system either through the urethra or from the bloodstream when there is an infection elsewhere. Most infections are limited to the bladder and the ureter but when an infection reaches a kidney, it can be a lot more dangerous and require immediate attention.

Pyelonephritis is more commonly known as UTI or urinary infection.

Causes: This can be an acute or a chronic condition.

• The acute condition more often happens subsequent to a bladder infection, which is not completely cured
• The chronic condition develops due to recurrent infections, kidney stones, kidney failure, and impaired renal flow
• People who have impaired immunity, poorly controlled diabetes, and higher blood pressure levels are at risk
• Women and pregnancy in particular increases the risk, as the urethra in women is shorter and puts them at greater risk of developing the infection

Symptoms:
Similar to any infection, pyelonephritis also includes general symptoms like:

• High fever with shaking chills
• Abdominal fullness
• General lethargy and fatigue
• Vomiting and diarrhoea
• Warm skin with profuse sweating
• Severe cases can present with confusion

More specific symptoms include:

• Abdominal/flank pain on either side
• Bloody or cloudy urine that can be foul-smelling
• Increased frequency and urgency
• The feeling of incomplete emptying
• Painful urination

Testing/Diagnosis:

1. The clinical exam can present with tenderness in the flank region
2. Blood culture can reveal infection
3. Urinalysis reveals impaired urine function including high levels of protein and blood
4. CT scan of the abdomen area may reveal swollen kidneys
5. Kidney biopsy, scan, and ultrasound may be very rarely required

Treatment:

• This is an acute condition, and when the elderly/pregnant are affected, immediate treatment is required
• Antibiotics are required to control the infection. The blood culture can guide to the most effective antibiotic.
• Pain relief requires the use of pain killers
• Acute cases may require admission to the hospital, with additional hydration support
• If the patient is not able to retain oral medications, they may be given as injections (antibiotics and pain killers)
• Chronic cases may require longer use of antibiotics. Also, given the risk factors, recurrent infections need to be constantly
• Potential complications include kidney failure, recurrent infections, and chronic sepsis which can result in infection in the other organs

Prevention:

1. Hygienic toilet habits, particularly when using public restrooms
2. Hygienic sexual habits, to prevent the entry of bacteria into the urinary tract
3. Adequate hydration to ensure wastes and bacteria are eliminated
4. Immediate treatment if you are prone to recurrent urinary infections