Pyelonephritis

Question 1

What is pyelonephritis?

Answer 1

Bacterial infection of the kidney affecting the parenchyma, calyces or renal pelvis
May be acute or chronic

Question 2

What are the common causitive organisms in pyelonephritis?

Answer 2

Gram- bacteria (e.g. E. coli, Klebsiella, Proteus Pseudomonas)

Question 3

What are the symptoms of acute pyelonephritis?

Answer 3

Fever, chills, rigors
Lumbar tenderness
Pain
Dysuria
Frequency

Question 4

What changes occur to renal function in pyelonephritis?

Answer 4

Usually normal

Question 5

What can be found in urine in acute pyelonephritis?

Answer 5

Bacteria

WBCs

Question 6

What can be seen histologically in acute pyelonephritis?

Answer 6

Sometimes large purple clumps (accumulations of bacteria)

Exudate in tubules (can be seen macroscopically as white streaks in the medulla)

Question 7

What kidney changes does chronic pyelonephritis cause?

Answer 7

Interstitial scarring
Tubular atrophy
Depressed “saddle shaped” scars on renal surface

Question 8

What is reflux nephropathy?

Answer 8

Renal damage due to backflow of urine from lower UT

All scarred kidneys in setting of reflux consider to have element of infection