Pyelonephritis Flashcards
What is Pyelonephritis?
Inflammation of the kidney and renal pelvis (bacterial infection of the kidney)
In ages of one or less what gender is more likely to get pyelonephritis?
Males due to higher incidence of congenital urinary tract anatomic abnormalities.
In patients 1-50 what gender is most affected by Pyelonephritis?
Females due to shorter urethral route
In patients over 50 in what gender is the incidence highest.
Incidence equalizes over 50.
What is the most common cause of acute pyelonephritis?
E. Coli (by far the highest)
Where do most bacterial infections of the kidney originate?
Bladder (ascending)
What is another origin of pyelonephritis?
Hematogenus (blood)
What is the usual infectious agent in Hematogenus origin Pyelonephritis?
Staphlococcus aureus (and its usually part of multiple organs with hematogenous infection.
How can catheters play a role in pyelonephritis?
Infections can develop around thrombus around long standing catheters
What are the usual causes of ascending infections (ascending pyelonephritis) in babies?
Congenital malformation of valves between ureters and bladder
What is the usual cause of ascending pyelonephritis in non babies?
Vesicoureteral reflux
-bladder over distended with infected urine
What type of cellular infiltration is associated with pyelonephritis?
Neutrophilic infiltration
What type of necrosis is associated with pyelonephritis?
Liquefactive leading to abscess formation
What is the term used to describe infected ous filling and distending the renal calyces pelvis and ureter?
Pyonephrosis
What is a perinephric abscess?
Necrotizing infection spreading through the renal capsule into surrounding fat.
How does pyelonephritis affect the papillary tip?
Papillary necrosis especially if the is concurrent diabetes mellitus that has caused disease of sparse blood vessels in the papillary tip
What is emphysematous pyelonephritis?
A gas condition caused by the infecting organism in pyelonephritis
What are some of the symptoms associated with Acute pyelonephritis?
- Dysuria
- Urinary Frequency
- Urinary Urgency
- Suprapubic pain
- Hematuria
- Systemic symptons; fever, chills, malaise
What may patients with pyelonephritis present with?
- Flank pain
- Costovertebral tenderness
- Sepsis/Urosepsis
- Pus in urine
What is the treatment for Pyelonephritis?
Intravenous Antibiotics
What is the result of Chronic pyelonephritis?
Scarring which may be limited to the pelvis or calyces or could extend the full thickness of the parenchyma out to the capsule causing dpressions of the cortical surface
What are the signs of chronic pyelonephritis?
- Inflammation primarily with lymphocytes and plasma cells primarily involving the interstitium.
- Fibrosis
- Thyrodization
- renal tubules become atrophic and distended with inspissated urine causing them to resemble thyroid follicles
