Pyelonephritis Flashcards
1
Q
what is this?
A
infection in renal pelvis and parenchyma
2
Q
risk factors?
A
- female
- structural urological abnormalities
- diabetes
3
Q
most common causative organisms?
A
- E.Coli
- Klebsiella
- Pseudomonas
- Enterococcus
4
Q
Presentation?
A
- loin to groin pain
- dysuria
- frequency
- haematuria
systemically:
- pyrexia
- rigors
- nausea & vomiting
5
Q
O/E?
A
pain on bimanual palpation of kidney
6
Q
ix?
A
- urine dipstick
- blood
- protein
- leucocytes - produced by neutrophils
- nitrites
- Urine MC&S
- Bloods
- FBC, CRP, LDH
- cultures
- USS useful to screen for underlying urological abnormalities
7
Q
how are nitrites produced?
A
gram negative organisms metabolise nitrates in urine (normal) to nitrites
8
Q
Mx?
A
- Broad spectrum Abx until culture & sensitivities available
- co-amoxiclav
- then targeted empirical Abx
- IV fluids
- Analgesia
- Antipyretics
9
Q
complications of chronic pyelonephritis?
A
- leads to scarring of renal parenchyma
- can result in CKD
- can result in abscess and/or pus in or around the kidney
10
Q
what investigation is done in recurrent pyelo to assess for complications?
A
DMSA scan
involves injecting radiolabelled DMSA into kidneys and this will show any areas of scarring
11
Q
treatment of it in the community?
A
Co-amox / ciprofloxacin for 7-10days
