Pyelonephritis - Infection of the Kidneys and Ureters

Pyelonephritis is a bacterial infection of the kidneys and the tubes taking urine to the bladder. It may be acute when the inflammation is sudden or chronic if the infection is long standing and would not clear.

The infection usually occurs as a result of another urinary tract infection such as a bladder infection. In most cases the cause is a reflux of infected urine from the bladder.

The bacteria that can cause pyelonephritis are: Escherichia coli (E-Coli), Klebsiella, Proteus or Pseudomonas.

Signs and Symptoms

• Flank and back pain
• High temperature
• Foul smelling urine
• Frequency of urinating
• Painful urinating
• General ill feeling
• Fatigue
• Nausea and vomiting

Tests - Urine tests for culture will identify the bacteria causing the infection, so that an appropriate antibiotic can be ordered.

• Urine tests for blood cells will show the presence of both red and white blood cells in the urine
• Blood culture
• An intravenous pyelogram may be done to determine if there is damage to the kidney and ureters

Risk factors- Pyelonephritis can affect people of both sexes and all ages; however, it is commoner in the adult female. Those especially vulnerable are the elderly, cancer patients and those with the HIV infection. It is less common than cystitis, which is a risk factor for pyelonephritis

Some Predisposing Factors Are:

• History of cystitis
• History of kidney stones
• Chronic urinary tract infection

Treatment- Prompt treatment of pyelonephritis is recommended to prevent complications. The aim is to treat the infection by removing all traces of the bacteria. Symptoms will usually disappear within 72 hours of starting treatment.

A 10-14 day course of antibiotics will be given orally. If the infection is severe or if taking oral medication is difficult, the antibiotic of choice will be given intravenously. If the infection is chronic, antibiotics will be given for a longer period. Some antibiotics that may be used are: ampicillin, bactrim and septra.

Other medication will include analgesia for the pain and medication such as as aspirin to reduce the fever.

Hospitalization-If complications have developed or the patient is too sick, hospitalization will be necessary. The infection can then be monitored, further tests can be performed, or intravenous antibiotics given. Pregnant women and diabetics may require follow up care after treatment is completed.

Complications Of Pyelonephritis

• Kidney disease
• Hypertension
• Sepsis
• Chronic form of the infection

Preventive measures- At the first sign of pain on urinating or frequent passing of urine, you must increase fluid intake, drink more fluids than usual. These may be the first signs of a urinary tract infection. If symptoms persist after 24 hours see a health professional.

Other Actions:

• Keep the genital area clean
• Develop good hygiene practices: girls can be taught to
• Clean themselves front to back after using the toilet.
• Urinating immediately after intercourse will prevent any bacteria from being transferred to the urinary tract.
• Take the complete course of antibiotics

More health education on this and other health matters is available.

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