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Acute pyelonephritis – causes, symptoms, treatment

Acute pyelonephritis is an acute infection (recently acquired) of the kidney, called high urinary tract infection. 10-20% of women have in life at least once a UTI.


The kidneys become infected in 97% of cases with Escherichia coli. This bacterium normally is found in the digestive tract and is removed with faeces. Thanks to the particularly female genital area and shorter urethra than men, this bacterium has the opportunity to reach the urethra to the bladder (where quartered determines cystitis), and if defense mechanisms are overcome the bacterium will reach the kidneys. This way of infection is called high infection by ascending way.

Favorable factors for kidney infection with kidney stones, decreased fluid intake, decreased immunity.

In 3% of cases the infection is due to another infection in the body, which is disseminating by blood. The infection reaches the kidney through the blood to be filtered by it. In these cases the infections are caused by bacteria like streptococcus, staphylococcus, or viruses. The method of infection is downward in this case, by blood.


– Begins with the polaki-dysuria (sign of lower UTI): less urine, frequent urination with feeling of incomplete, sometimes with discomfort in urination.

– Fever occurs in spikes, more than 38 degrees.

– Back pain (kidney pain) to one side or both sides, can occur spontaneously, or induced (in tapping the area).

– There can be nausea, vomiting, loss of appetite, generalized malaise.

The clinical picture is often extremely suggestive for the diagnosis of pyelonephritis, being necessary to present immediately at the emergency for medical treatment establishment.

Antibiotics even after antibiogram are the curative treatment for acute pyelonephritis, but must be supplied with bed rest and fluid intake of 2500 ml per day.

Untreated correctly there can appear complications as: toxic-septic shock, sepsis, renal failure, kidney abscess, or chronic pyelonephritis that in turn evolves into chronic renal failure.

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