pyelonephritis Flashcards
defintions
infection of renal parenchyma/renal pelvis uusally bacterial
types
- aspostematous nephritis
- renal carbuncle (renal cortical abscess)
- paranephric abscess
- pyonephrosis
- infected hydropnephressit
- infected cyst
aspostematous nephritis
A lot of Puss foci on the surface of the kidney
enal carbuncle (renal cortical abscess)
The small for kind of post come together to one big focus
paranephric abscess
necrosis of tissues within the perinephric space surroundign the kidneys. surrounding the perinephric fat and fascia of kindeys
causes
stones
diabetes
pregnancy
neurogenic bladder ( spina bifida)
BPH
VUR
indwelling catheters
hematogenous spreaf e.g IE
symptoms
general - fever, RIGORS, VOMITING
local - pain and redness over the area
most common cause
ascending infection from the bladder
UNCOMPLICATED
no antomical anomolies
immune competent
normal renal function
not pregant
outpatient treatment is ok. oral fluorquinolone like ciprofloxacin or trimethoprim and sulfamehtozole
COMPLICATED
> 60 YEARS
need to be admitted to hospital
have congential abnormalities
pregs
immune weak
already bad fucntioning kindeys
requiremnts of urosepsis
- need a pus focus in urinary system
- need to have stasis of urine
- renal failure
what can cause urosepsis
any UTI
- purrulent cystsitis
- purrulent epididymitis
- purrulent pyelonephritis
- purulent epidymitis
- purrulent prostatitis
mb agenes in sepsi
gram -, e. coli KEB
and some gram +
managemnt in spesi s
tak 3 give 3
diagnosis
take 3 - bloods, urine, LACTATE
and ultrasound, KUB, ct with contrast
symptoms of cystsits
Urinary frequency
Dysuria
Urgency
Foul-smelling urine
Suprapubic pain
Clinical examination may be normal or may reveal suprapubic tenderness
dx of cystitis
The key differential is pylenopheritis
dx cystitis
he key differential is pylenopheritis
investigations for cystiis
disptcik
In uncomplicated cystitis no further investigations are required.
In children, men, and pregnant women a mid-stream urine sample should be sent.
tx of cystitis
First line management is with oral nitrofurantoin or trimethoprim.
The patient should be advised on conservative measures to reduce the risk of further infection e.g. regular fluid intake, post-coital voiding.
Definition of Pyelonephritis
most common mechnaism of uti
transurethral ascend of colonic commensals, most commonly E. coli.
most common mechnaism of uti
transurethral ascend of colonic commensals, most commonly E. coli.
DX OF PYELONEPHRITIS
CYSTITIS
Abnormal vital signs are more indicative of pyelonephritis
Nitrofurantoin
Nitrofurantoin is an antibacterial medication used to treat urinary tract infections, but it is not as effective for kidney infections.
urine results uti
nNitrites
Leucocytes
Haematuria
