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Acute Pyelonephritis: A bacterial infection of the kidney

Topic Pyelonephritis
FB Dr Soarawee
Soarawee Weerasopone, MD

Minimally Invasive Uro-Oncologist
Royal Phnom Penh hospital, Kingdom of Cambodia

The kidney-related infection is one among other diseases which is under Urologist’s responsibility. Definitely right! Today we are going to discuss about a bacterial infection of the kidney, they called it an “Acute Pyelonephritis”. This medical condition, mostly happened by a gram-negative bacterial named Escherichia coli, and here are their routes of the penetration.

E coli
E coli is the most common cause in Acute bacterial pyelonephritis
  1. In ascending infection from lower urinary tract
    • The most common cause of Acute Pyelonephritis.
    • E coli which lives as a normal flora in human feces very harmfully bacterium in urinary tract system.
    • E coli will use its leg-like structural climbing up through urethra, bladder, ureter and then if it reaching to kidney, Acute Pyelonephritis can be occurred.
  2. Hematogenous spread
    • Rarely etiology but usually, happened in a low-immunity patient.

There’s a report stating that, the Acute Pyelonephritis is 5 times or more found in female if compared to male patients. Young female with an active sexual condition, significantly found as the most common affected by the Acute pyelonephritis, and another group that considered as the secondly lured to this disease will goes to infants and elderly, and also in Pregnant women.

Healthy female
Young female with an active sexual conditions, significantly found as the most common affected by the Acute pyelonephritis.

The classical triad presenting symptoms of Acute Pyelonephritis are

  • Fever
  • Flank pain
  • Nausea or Vomiting

The symptom usually develops within an hour, painful urination and bloody urination can also present at the same time in female. In some cases, physical examination will reveal tenderness on flank percussion. Laboratory investigation such as urinalysis very usefully at this point, it often showed a lot of inflammatory cells. Imaging access is just an optional tool for helping diagnostic the acute pyelonephritis unless the clinical is really critically.

High grade fever
Febrile fever is 1 out of 3 classical signs.

Acute Pyelonephritis can be treated as an outpatient or inpatient at the same time, depends on patient’s condition by the way. Once the disease has diagnosed, urine culture must be collected for a definite identification for the pathogen and that would need at least 48 hours waiting the result. During this period of time, we will start the broad-spectrum antibiotic treatment in advance, when we know each type of the pathogen clearly then the narrow spectrum antibiotic will role after.

The prognosis of Acute Pyelonephritis will be recovered quickly if patient seek for medical treatment in time. Some serious complication can be occurred if they are delaying, for example, a renal abscess, serious gas-forming type kidney infection or even kidney failure.

The questions came up like; how to prevent the Acute Pyelonephritis; I must say that the prevention methodologies eventually are exactly the same as the ordinary urinary tract infection prevention.

Drink water
Drink plenty of water more than 2 Liters a day run as protective factor.
  1. Drink plenty of water more than 2 Liters a day.
  2. Don’t hold urinating.
  3. Wipe out from front to back after urination and defecation.
  4. Void urine once after finishing sexual intercourse.

If you have any questions about Acute Pyelonephritis, you can discuss with your trusted Urologist or it would be my honor if you text me. Take care!

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