Pyelonephritis

Question 1

What are the symptoms of pyelonephritis?

Answer 1

• high fever
• rigors
• vomiting
• loin pain + tenderness
• Oliguria
• haematuria (gross)

Question 2

What does a CT scan for pyelonephritis show?

Answer 2

wedge shaped areas of inflammation in the renal cortex

Question 3

What is chronic pyelonephrits?

Answer 3

Kidney infection caused by infection acquired in childhood and vesicoureteric reflux

Question 4

What does a CT of chronic pyelonephritis show?

Answer 4

• irregular renal outlines
• clubbed calyces
• reduction in renal size

Question 5

What are the complications of urinary reflux?

Answer 5

Reflux from childhood usually stops around puberty however the damage already done leads to progessive renal fibrosis and further loss of fucntions despite lack of infection.

Question 6

What Invx are done for pyelonephritis?

Answer 6

USS
CT
Bloods (FBC, U+Es, CRP, Blood cultures)
Urine dipstick (+ve nitrites or +ve leucocytes)
MSU microscopy, culture and sensitivity - haematuria (gross/microscopic), WBC+)

Question 7

What is the treatment for acute pyelonephritis?

Answer 7

IV Abx:

• aztreonam
• cefuroxime
• ciprofloxacin
• gentamicin

+ IV fluids

(then oral abx for 7 days)