(U)- Pyelonephritis Flashcards

1
Q

What is pyelonephritis?

A

Inflammation of the kidney due to bacterial infection

Inflammation affects the renal pelvis

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2
Q

What are the risk factors of pyelonephritis?

A

Female
Structural urological abnormalities
Vesico-ureteric reflux
Diabetes

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3
Q

What is the most common cause of pyelonephritis?

A

Escherichia coli

Gram negative
Anaerobic
Bacilli

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4
Q

What are some less frequent causes of pyelonephritis?

A

Klebsiella pneumoniae (gram-negative anaerobic bacilli)
Enterococcus
Pseudomonas aeruginosa
Staphylococcus saprophyticus
Candida albicans

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5
Q

How do patients with pyelonephritis present?

A

LUTS + Triad of symptoms:

Fever
Loin or back pain
Nausea/vomiting

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6
Q

What symptoms may patients with pyelonephritis may also have asides from the regular triad?

A

Systemic illness
Loss of appetite
Haematuria
Renal angle tenderness (on examination)

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7
Q

What investigations should be used for pyelonephritis?

A

Urine dipstick

MSU for microscopy, culture and sensitivity

Blood tests

Imaging to exclude other pathology e.g. ultrasound or CT

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8
Q

How is pyelonephritis managed?

A

Referral to hospital if there are features of sepsis if not

7-10 days of
Cefalexin

Co-amoxiclav (if cultures are available)

Trimethoprim (if cultures are available)

Ciprofloxacin (tendon damage and lowered seizure threshold risk)

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9
Q

If patients do not respond well to treatment of pyelonephritis, what should be considered?

A

Renal abscess

Kidney stone- obstructing ureter causing pyelonephritis

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10
Q

What can recurrent kidney infections lead to?

A

Scarring of the renal parenchyma leading to CKD

May also progress to end-stage renal failure

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11
Q

What is used in recurrent pyelonephritis to assess for renal damage?

A

DMSA scans

Inject radiolabelled DMSA which builds up in healthy kidney tissue, but not damaged tissue

When imaged, indicates scarring or damage

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