Pyelonephritis - Edubirdie

University:
The University Of Western Ontario
Course:
ANAT 2200B | Systemic Anatomy of the Human Body
Academic year:

2022
Views:

333

Pages:

2
Author:

Kyuwon J.

Pyelonephritis ● acute/chronic bacterial infection on kidney parenchyma +renal pelvis ○ Resulted from ascending infection in lower urinary tracts ● Common cause ○ Escherichia coli ⇒ most common ○ Klebisella spp ○ Proteus spp ○ Enterococcus spp ○ Staphylococcus saprophyticus ● Path ○ Bacterial colonization on urethra ○ Infection of bladder ■ Cystitis ○ Ascension through ureters ○ Infection in renal pelvis + parenchyma ● Hematogenous spread is considered rare ○ Staphylococcus aureus bacteremia Rx ● Female gender ○ Tends to have shorter urethra more vulnerable on attacks ● Pregnancy ● Urinary tract obstruction ○ Stones ○ Strictures ● ● ● ● Vesicoureteral reflux Diabetic mellitus Indwelling of the urinary catheter Immunosuppression S/smx ● ● ● ● ● Fever Flank pain Chills/rigors Nausea/vomiting Dysuria ○ Frequency ○ Urgency ○ Lower UTI symptoms ● Costovertebral angle ○ CVA ● Tachycardia ● Hypotensions ○ Only if its septic Ix ● Urinalysis ○ Pyruia ■ Increase in WBCs ○ Bacteriuria ○ Positive nitrites ■ Gram-negative organisms ○ Positive Leukocyte esterase ○ With or without hematuria ● Urine culture ○ Confirmation of organism ○ Gives clue to antibiotic therapy ● Blood tests ○ Increase in WBC counts ○ Increase in both CRP and ESR ○ Used when its severe or septic ● Imaging ○ CT abdomen or pelvis ○ Renal ultrasound ○ Only if indicated