Acute Pyelonephritis Flashcards
Acute pyelonephritis
Inflammation of renal parenchyma and collecting system
Most commonly caused by bacteria
Fungi, protozoa, or viruses can also infect kidneys
Urosepsis
Systemic infection from urologic source
Prompt diagnosis/treatment critical
-can lead to septic shock and death
Frequent causes
E. coli
Proteus
Klebsiella
Enterobacter
Etiology and patho
Usually begins with colonization and infection of lower tract via ascending urethral route
Preexisting factors usually present
-vesicoureteral reflux
-dysfunction of lower urinary tract
Vesicoureteral reflux
Backward movement of urine from lower to upper urinary tract
Dysfunction of lower urinary tract
Obstruction from BPH
Stricture
Urinary stone
What can recurring episodes lead to?
Scarred, poorly function kidney and chronic pyelonephritis
Clinical manifestations
Mild fatigue Fever with chills Vomiting, malaise Flank pain Cystitis (dysuria, urgency, frequency) Costovertebral tenderness on affected side Bacteriuria and pyuria
Lab tests
Urinalysis Urine for culture and sensitivity CBC with differential Blood culture (if bacteremia is suspected) US and CT urography
Drug therapy
Antibiotics NSAIDs or antipyretic durgs Urinary analgesics Adequate fluid intake/IVF Prophylaxis may be used for recurrent infection
Objective findings
Fever Hematuria Foul smelling urine Tender, enlarged kidney Leukocytosis Positive findings for bacteria, WBCs, RBCs Pyuria Ultrasound, CT scan and IVP abnormalities
If a patient has colonization of bacteria…
Patient will ALWAYS have that bacteria
