Pyelonephritis is a urinary tract infection, usually caused by bacteria from the bladder, which reaches the kidneys causing inflammation. These bacteria are normally present in the intestine, but due to some condition they can proliferate and reach the kidneys.
E. coli is a gram-negative bacterium that normally inhabits the intestines, being responsible for approximately 90% of pyelonephritis cases.
This inflammation is more common in babies under one year old, women, because of the greater proximity between the anus and the urethra, and in men with benign prostatic hyperplasia, as there is an increase in urinary retention.
Pyelonephritis can be classified as:
- Acute pyelonephritis, when the infection appears suddenly and intensely, disappearing after a few weeks or days; Chronic pyelonephritis, which is characterized by recurrent bacterial infections that have not been well cured, causing prolonged inflammation in the kidney and serious injuries that can lead to kidney failure.
Main symptoms
The most characteristic symptoms of pyelonephritis are pain in the lower back, pelvic, abdominal and back. Other symptoms are:
- Pain and burning when urinating; Constant urge to urinate; Smelly urine; Malaise; Fever; Chills: Nausea; Sweating; Vomiting; Cloudy urine.
In addition, urine tests indicate the presence of numerous bacteria and leukocytes, in addition to blood, in some cases. See what are the symptoms of urinary tract infection.
In addition to the acute and chronic forms, pyelonephritis can be called emphysematous or xanthogranulomatous according to the symptoms that arise. In emphysematous pyelonephritis there is an accumulation of gases produced by bacteria present in the kidney, being more common in diabetics, while xanthogranulomatous pyelonephritis is characterized by an intense and constant inflammation of the kidney, which leads to its destruction.
Pyelonephritis in pregnancy
Pyelonephritis in pregnancy is usually due to a prolonged bladder infection, usually caused by bacteria or fungi like Candida albicans .
In pregnancy, kidney infections are quite common, because the increase in hormone levels such as progesterone leads to relaxation of the urinary tract, facilitating the entry of bacteria in the bladder and its multiplication. When the infection is not diagnosed or treated, the microorganisms multiply and begin to rise in the urinary tract, reaching the kidneys and causing their inflammation.
Treatment of pyelonephritis in pregnancy can be done with antibiotics, which have no effect on the baby's development, according to the sensitivity profile of the microorganisms and have no effect on the baby's development.
How the treatment is done
Treatment of pyelonephritis is usually done with antibiotics according to the sensitivity profile of the microorganism and should start as soon as possible to prevent kidney damage and prevent bacteria from spreading into the bloodstream causing septicemia. Analgesics and anti-inflammatory drugs can be used to relieve pain.
When pyelonephritis is caused by obstruction or malformation of the kidney, surgery may be necessary to correct the problem.
Acute pyelonephritis, when left untreated, can favor the occurrence of septicemia, kidney abscess, kidney failure, hypertension and chronic pyelonephritis. In case of chronic pyelonephritis, severe kidney damage and kidney failure, in addition to the use of antibiotics, dialysis may be required every week to filter the blood.
How the diagnosis is made
The diagnosis of pyelonephritis is made by the urologist through the evaluation of the patient's symptoms, physical examination such as palpation of the lumbar region and urine examination to identify the presence of blood, leukocytes and bacteria in the urine. Ultrasound, x-ray and computed tomography or magnetic resonance imaging exams can be performed to confirm the diagnosis, depending on each case.
Uroculture and antibiogram can also be requested by the doctor in order to identify which agent causes pyelonephritis and establish the best line of treatment. Understand how urine culture is made.
Pyelonephritis can be confused with urethritis and cystitis, since they are all infections of the urinary tract. However, pyelonephritis corresponds to an infection that affects the kidneys, while in cystitis the bacteria reach the bladder and in urethritis, the urethra. Find out what urethritis is and how to treat it.
