Pyelonephritis

Question 1

Acute pyelonephritis definition

Answer 1

Bacterial infection with inflammation of kidney

Question 2

Sex more at risk of pyelonephritis

Answer 2

Female

Question 3

Demographic more at risk of pyelonephritis

Answer 3

Young sexually active women
Pregnant patient
Patient with kidney stones

Question 4

2 ways of spread of infection to kidney in pyelonephritis

Answer 4

Hematogenous (uncommon )
Ascending urinary tract infection

Question 5

Main causes of pyelonephritis

Answer 5

Gram - negative bacterial ( e.coli mostly ) most common

Proteus
Klebsiella
Entérobacter

Question 6

Symptoms of pyelonephritis

Answer 6

Fever
Chills
Flank pain
Costovertebral angle pain / tenderness
Nausea , vomiting
Anorexia
Cystitis symptoms (urgency , frequency , dysuria)
Epigastric pain and lower abdominal pain (uncommon )

Question 7

Complications

Answer 7

Bacteremia
Sepsis
Shock
Multiple organ system dysfunction
Acute renal failure

Question 8

When is pyelonephritis considered complicated

Answer 8

Pregnant
Uncontrolled diabetes
Kidney failure
Kidney transplant
Immunocompromised
Extreme of age
Male

Question 9

Lab investigation

Answer 9

Urinalysis with pyuria, bacteriuria
Urine culture

Question 10

Treatment

Answer 10

Rehydration to prevent AKI
Antibiotics 7-14 days (Oral Fluoroquinolones )

If hospitalized - IV ceftriaxone, pip-tazo, Fluoroquinolones