Pyelonephritis Flashcards
What are the signs and symptoms of pyelonephritis?
flank pain fever nausea/vomiting CVA tenderness (R>L) bacteriruia (20 p HPF) pyuria (culture)
What evaluation do you perform on a pregnant patient suspected of having pyelonephritis?
A clean catch urine culture and antimicrobial susceptibility testing
CBC, electrolytes, Cr
What are the most common bacteria that cause pyelonephritis?
Escherichia coli
Proteus
Klebsiella
Enterobacter
What is your first-line antibiotic of choice in treatment of pyelonephritis?
Cephalosporins
Do you admit pregnant women to the hospital when diagnosed with pyelonephritis?
Yes
How long should the patient remain in hospital?
24-48 hours from being afebrile
What are the fetal risks to pyelonephritis in pregnancy?
preterm delivery
low birth weight
If the patient is admitted with pyelonephritis and develops contractions at 28 weeks gestation, do you recommend tocolysis?
Yes
Are steroids for fetal benefits appropriate in a patient with pyelonephritis?
No
What are the maternal risks to pyelonephritis in pregnancy?
anemia
septicemia
ICU admission
transient renal dysfunction pulmonary insufficiency
How do you evaluate the patient who does not respond promptly to IV antibiotic therapy?
Renal ultrasound
What do you suspect if the patient does not respond promptly to IV antibiotic therapy for UTI?
renal abscess
ureter obstruction
other abdominal infections
