Materiały źródłowe

• #1 Acute Pyelonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519537/

  Acute pyelonephritis is a bacterial infection causing inflammation of the kidneys. Pyelonephritis is generally a complication of an ascending urinary tract infection that spreads from the bladder to the kidneys. […] Symptoms usually include fever, flank pain, nausea, vomiting, burning with urination, increased urinary frequency, and urgency. […] It is important to differentiate acute pyelonephritis, a medical condition treated primarily with antibiotics, from pyonephrosis (obstructive pyelonephritis), a clinically similar condition that requires urgent surgical drainage of an obstructed, infected renal pelvis. […] The role of imaging is discussed, and suggested empiric antibiotics are identified. This activity outlines the clinical presentation, diagnosis, and management of acute pyelonephritis and highlights the role of the interprofessional team in caring for patients with the condition.

• #2 Kidney infection – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kidney-infection/symptoms-causes/syc-20353387

  A kidney infection is a type of urinary tract infection (UTI). A kidney infection may begin in the tube that carries urine from the body (urethra) or in the bladder. The infection can travel to one or both kidneys. A kidney infection is also called pyelonephritis. […] A kidney infection needs prompt medical treatment. If not treated properly, an infection can cause lasting damage to the kidneys. Or the bacteria can spread to the bloodstream and cause a dangerous infection. […] Make an appointment with your health care provider if you have symptoms of a kidney infection. Also see your provider if you’re being treated for a UTI but your symptoms aren’t getting better. […] If left untreated, a kidney infection can lead to potentially serious complications, such as kidney scarring. […] Bacteria that enter the urinary tract through the urethra can multiply and travel to your kidneys. This is the most common cause of kidney infections. […] Factors that increase the risk of a kidney infection include being female. […] A kidney infection that occurs during pregnancy can increase the risk of having a baby with a low birth weight.

• #3 Acute Pyelonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519537/

  Acute pyelonephritis is a bacterial infection causing inflammation of the kidneys. Pyelonephritis is generally a complication of an ascending urinary tract infection that spreads from the bladder to the kidneys. […] Symptoms usually include fever, flank pain, nausea, vomiting, burning with urination, increased urinary frequency, and urgency. […] It is important to differentiate acute pyelonephritis, a medical condition treated primarily with antibiotics, from pyonephrosis (obstructive pyelonephritis), a clinically similar condition that requires urgent surgical drainage of an obstructed, infected renal pelvis. […] The role of imaging is discussed, and suggested empiric antibiotics are identified. This activity outlines the clinical presentation, diagnosis, and management of acute pyelonephritis and highlights the role of the interprofessional team in caring for patients with the condition.

• #4 Kidney infection

  https://www.nhs.uk/conditions/kidney-infection/

  A kidney infection is a painful type of urinary tract infection that can affect one or both kidneys. It can be serious if it’s not treated. […] If the GP thinks you have a kidney infection, you’ll have your pee tested to check. […] The main treatment for a kidney infection is antibiotic tablets, which you’ll usually take for 7 to 14 days. […] If you have a long-term health condition, or you’re pregnant, you may need to go to hospital to have antibiotics through a drip. […] In hospital, you’ll have regular blood and urine tests to check your health and to make sure the antibiotics are working. […] A kidney infection is a type of urinary tract infection (UTI). […] UTIs are caused by bacteria in the tube that carries pee out of your body (uretha). […] A kidney infection is often caused by cystitis, another type of UTI. But you can also have one without having cystitis.

• #5 Diagnosis and Treatment of Acute Pyelonephritis in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0901/p519.html

  Acute pyelonephritis is a common bacterial infection of the renal pelvis and kidney most often seen in young adult women. History and physical examination are the most useful tools for diagnosis. Most patients have fever, although it may be absent early in the illness. Flank pain is nearly universal, and its absence should raise suspicion of an alternative diagnosis. A positive urinalysis confirms the diagnosis in patients with a compatible history and physical examination. Urine culture should be obtained in all patients to guide antibiotic therapy if the patient does not respond to initial empiric antibiotic regimens. […] A urine culture and antimicrobial susceptibility testing should be performed in women with suspected acute pyelonephritis. Initial empiric therapy should be selected based on the likely infecting uropathogen and local antibiotic sensitivity patterns.

• #6 Diagnosis and Treatment of Acute Pyelonephritis in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0901/p519.html

  Acute pyelonephritis is a common bacterial infection of the renal pelvis and kidney most often seen in young adult women. History and physical examination are the most useful tools for diagnosis. Most patients have fever, although it may be absent early in the illness. Flank pain is nearly universal, and its absence should raise suspicion of an alternative diagnosis. A positive urinalysis confirms the diagnosis in patients with a compatible history and physical examination. Urine culture should be obtained in all patients to guide antibiotic therapy if the patient does not respond to initial empiric antibiotic regimens. […] A urine culture and antimicrobial susceptibility testing should be performed in women with suspected acute pyelonephritis. Initial empiric therapy should be selected based on the likely infecting uropathogen and local antibiotic sensitivity patterns.

• #7 Diagnosis and Treatment of Acute Pyelonephritis in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0901/p519.html

  Acute pyelonephritis is a common bacterial infection of the renal pelvis and kidney most often seen in young adult women. History and physical examination are the most useful tools for diagnosis. Most patients have fever, although it may be absent early in the illness. Flank pain is nearly universal, and its absence should raise suspicion of an alternative diagnosis. A positive urinalysis confirms the diagnosis in patients with a compatible history and physical examination. Urine culture should be obtained in all patients to guide antibiotic therapy if the patient does not respond to initial empiric antibiotic regimens. […] A urine culture and antimicrobial susceptibility testing should be performed in women with suspected acute pyelonephritis. Initial empiric therapy should be selected based on the likely infecting uropathogen and local antibiotic sensitivity patterns.

• #8 Effective COPD Diagnosis and Treatment in Miami | Larkin Pulmonology

  https://larkinhealth.com/en/treatments-services/nephrology/kidney-infection/diagnosis-and-treatment/

  Diagnosing a kidney infection, also known as pyelonephritis, involves a combination of medical evaluation, patient history, physical examination, and diagnostic tests. Proper diagnosis is crucial for timely and accurate treatment. […] A urinalysis is one of the initial tests performed. It involves analyzing a urine sample to check for the presence of bacteria, white blood cells, red blood cells, and other indicators of infection. […] A urine culture may be ordered to identify the specific type of bacteria causing the infection. This information helps guide antibiotic treatment. […] Blood tests, such as a complete blood count (CBC) and a blood culture, may be done to assess the severity of the infection and its impact on your overall health. […] Imaging tests like ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) may be performed to visualize the kidneys and urinary tract for any abnormalities, obstructions, or signs of infection. […] Timely diagnosis is crucial to prevent complications. If a kidney infection is suspected, prompt treatment can help prevent the infection from worsening and causing further damage.

• #9 Diagnosis of Kidney Infection (Pyelonephritis) – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-infection-pyelonephritis/diagnosis

  Health care professionals use your medical history, a physical exam, and lab and imaging tests to diagnose a kidney infection. […] Health care professionals may use urinalysis, urine culture, and imaging tests to diagnose a kidney infection. […] Urinalysis checks your urine sample for blood in the urine and white blood cells. Your body produces white blood cells when it is fighting an infection caused by bacteria. […] Urine culture identifies some common types of bacteria in your urine. […] Blood tests look for serious infections, such as kidney infections. […] Your health care professional may use one or more of the imaging tests below to help diagnose a kidney infection.

• #10 Leukocytes in the urine: Causes, symptoms, and diagnosis.

  https://www.medicalnewstoday.com/articles/314165

  High leukocyte levels in the urine may mean a urinary tract infection or other underlying inflammatory medical problems, such as kidney infection and kidney stones. […] The number of white blood cells in the urine can increase if there is a kidney infection. […] A urinary tract infection (UTI) is a common cause of leukocytes in the urine. […] If a person presents with symptoms of a UTI or other urinary tract dysfunction, doctors will perform tests to diagnose the underlying cause. […] Doctors will first order a urine analysis (urinalysis) to screen the urine for abnormalities which may be enough to detect any problems. […] The presence of leukocytes might be a sign of infection. […] A correct diagnosis is vital for identifying a path of treatment. […] High levels of leukocytes in the urine typically indicate an infection in the urinary system.

• #11 Acute pyelonephritis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/551

  Urinalysis and urine culture confirm the diagnosis of pyelonephritis. Urine cultures, obtained prior to treatment, demonstrate bacteria, most often Escherichia coli. […] 1st investigations to order: urinalysis, urine culture and sensitivity, full blood count, erythrocyte sedimentation rate, C-reactive protein, urea and electrolytes, creatinine, blood culture (in hospital). […] Diagnostic investigations include renal ultrasound, contrast-enhanced CT, and MRI.

• #12 Pyelonephritis – Wikipedia

  https://en.wikipedia.org/wiki/Pyelonephritis

  Pyelonephritis is inflammation of the kidney, typically due to a bacterial infection. Symptoms most often include fever and flank tenderness. Other symptoms may include nausea, burning with urination, and frequent urination. Diagnosis is typically based on symptoms and supported by urinalysis. If there is no improvement with treatment, medical imaging may be recommended. Analysis of the urine may show signs of urinary tract infection. Specifically, the presence of nitrite and white blood cells on a urine test strip in patients with typical symptoms are sufficient for the diagnosis of pyelonephritis, and are an indication for empirical treatment. Blood tests such as a complete blood count may show neutrophilia. Microbiological culture of the urine, with or without blood cultures and antibiotic sensitivity testing are useful for establishing a formal diagnosis, and are considered mandatory. If a kidney stone is suspected, a kidneys, ureters, and bladder x-ray (KUB film) may assist in identifying radioopaque stones. Where available, a noncontrast helical CT scan with 5 millimeter sections is the diagnostic modality of choice in the radiographic evaluation of suspected nephrolithiasis. In patients with recurrent ascending urinary tract infections, it may be necessary to exclude an anatomical abnormality, such as vesicoureteral reflux or polycystic kidney disease. Investigations used in this setting include kidney ultrasonography or voiding cystourethrography. Ultrasound findings that indicate pyelonephritis are enlargement of the kidney, edema in the renal sinus or parenchyma, bleeding, loss of corticomedullary differentiation, abscess formation, or areas of poor blood flow on doppler ultrasound. A DMSA scan is a radionuclide scan that uses dimercaptosuccinic acid in assessing the kidney morphology. It is now the most reliable test for the diagnosis of acute pyelonephritis.

• #13 Acute Pyelonephritis Workup: Approach Considerations, Collection of Urine Specimens, Urinalysis

  https://emedicine.medscape.com/article/245559-workup

  Urine culture is indicated in any patient with pyelonephritis, whether treated in an inpatient or an outpatient setting, because of the possibility of antibiotic resistance. Reliable results require proper specimen collection. […] Blood cultures are indicated in any patient who is being admitted or who has already been admitted. Approximately 12-20% of patients have cultures that are positive for infection. Bacteremia has not been associated with a poor outcome unless sepsis or another significant comorbidity is present. […] Imaging may be required to make the diagnosis in infants and children in whom pyelonephritis presents insidiously. Imaging is warranted at the time of admission in patients with the following conditions: AIDS, poorly controlled diabetes, organ transplant (particularly kidney), other immunocompromised state, sepsis syndrome, septic shock.

• #14 Diagnosis and Treatment of Acute Pyelonephritis in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0901/p519.html

  All patients with suspected acute pyelonephritis should have a urine culture and antimicrobial susceptibility testing to guide possible adjustment of the initial antimicrobial regimen (if there is no improvement) and selection of step-down oral therapy for patients treated initially with intravenous therapy. […] Most women with acute pyelonephritis do not need imaging studies unless symptoms do not improve or there is a recurrence. […] Blood cultures are commonly obtained from patients with acute pyelonephritis who are ill enough to warrant hospital admission, although they may not routinely be necessary in patients with uncomplicated acute pyelonephritis. Approximately 15 to 30 percent of patients with acute pyelonephritis are found to be bacteremic; older persons and those with complicated acute pyelonephritis are more likely to have bacteremia and sepsis.

• #15 Kidney Infection (Pyelonephritis): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15456-kidney-infection-pyelonephritis

  Kidney infections are a type of urinary tract infection that usually moves from your bladder to your kidneys. […] Kidney infections can be more serious than lower UTIs. See a healthcare provider if you have symptoms of a kidney infection. […] A healthcare provider diagnoses a kidney infection by reviewing your symptoms and testing your pee for signs of infection (urinalysis). […] Only a healthcare provider can diagnose you with a kidney infection. If you have symptoms of a urinary tract infection with fever and pain in your side, you might have a kidney infection. […] Healthcare providers treat kidney infections with antibiotics. You’ll have to take antibiotics for at least 14 days. […] You should start feeling better within two to three days of starting antibiotics. It may take longer for some people.

• #16 Diagnosis and Management of Acute Pyelonephritis in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0301/p933.html

  There are approximately 250,000 cases of acute pyelonephritis each year, resulting in more than 100,000 hospitalizations. […] Urine cultures are positive in 90 percent of patients with acute pyelonephritis, and cultures should be obtained before antibiotic therapy is initiated. […] Blood cultures should be obtained in patients with acute pyelonephritis only if there is diagnostic uncertainty, the patient is immunosuppressed, or a hematogenous source is suspected. […] To diagnose acute pyelonephritis, physicians must rely on evidence of UTI from urinalysis or culture, along with signs and symptoms suggesting upper UTI (fever, chills, flank pain, nausea, vomiting, costovertebral angle tenderness). […] Urinalysis and urine culture confirm the diagnosis of acute pyelonephritis. […] The consensus definition of pyelonephritis established by the Infectious Diseases Society of America (IDSA) is a urine culture showing at least 10,000 colony-forming units (CFU) per mm3 and symptoms compatible with the diagnosis.

• #17 Diagnosis and Management of Acute Pyelonephritis in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0301/p933.html

  Urine cultures are positive in 90 percent of patients with acute pyelonephritis, and culture specimens should be obtained before initiation of antibiotic therapy. […] A seven- to 14-day course of antibiotics is effective in women who are immunocompetent and do not have underlying illness. […] Post-treatment urine cultures are recommended in all patients at the follow-up visit, one to two weeks after completion of antibiotic therapy.

• #18 Acute Pyelonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519537/

  A urine specimen should always be obtained for a urinalysis and culture in patients suspected of pyelonephritis. […] On urinalysis, pyuria is the most common finding in patients with acute pyelonephritis. […] The diagnosis is typically made clinically, and imaging is not required but should be considered for high-risk cases or if urolithiasis is suspected. […] Most uncomplicated cases of acute pyelonephritis will be caused by E. coli, for which patients can generally be treated with oral cephalosporins, quinolones, or TMP-SMX, depending on community bacterial resistance patterns and specific culture results. […] Always obtain urine cultures before giving any antibiotics. […] Consider a catheterized urine specimen if the clean voided samples are contaminated. […] A specific physician should be responsible for checking the urine cultures, communicating with the patient, and adjusting therapy accordingly. […] When appropriate treatment fails, obtain imaging (usually CT scanning) and ask for help from urology and/or infectious disease.

• #19 Acute pyelonephritis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/551

  Urinalysis and urine culture confirm the diagnosis of pyelonephritis. Urine cultures, obtained prior to treatment, demonstrate bacteria, most often Escherichia coli. […] 1st investigations to order: urinalysis, urine culture and sensitivity, full blood count, erythrocyte sedimentation rate, C-reactive protein, urea and electrolytes, creatinine, blood culture (in hospital). […] Diagnostic investigations include renal ultrasound, contrast-enhanced CT, and MRI.

• #20 Kidney Infection (Pyelonephritis): Symptoms & Treatment

  https://www.health.com/kidney-infection-overview-7498691

  A kidney infection, or pyelonephritis, is a serious medical condition that occurs when harmful bacteria enter and infect the kidneys. […] Kidney infections can cause significant discomfort and may lead to complications if not treated promptly. […] To diagnose a kidney infection (pyelonephritis), healthcare professionals typically employ a combination of methods to assess symptoms, conduct physical examinations, and perform diagnostic tests. […] The diagnostic process may involve the following: Medical history and physical examination: Your healthcare provider will want to determine what risk factors you have, if any. They can also help narrow down any lifestyle factors that may be causing your symptoms. […] Urinalysis collection: This checks for bacteria, white blood cells (indicating an immune response), and red blood cells.

• #21 Pyelonephritis – Wikipedia

  https://en.wikipedia.org/wiki/Pyelonephritis

  Pyelonephritis is inflammation of the kidney, typically due to a bacterial infection. Symptoms most often include fever and flank tenderness. Other symptoms may include nausea, burning with urination, and frequent urination. Diagnosis is typically based on symptoms and supported by urinalysis. If there is no improvement with treatment, medical imaging may be recommended. Analysis of the urine may show signs of urinary tract infection. Specifically, the presence of nitrite and white blood cells on a urine test strip in patients with typical symptoms are sufficient for the diagnosis of pyelonephritis, and are an indication for empirical treatment. Blood tests such as a complete blood count may show neutrophilia. Microbiological culture of the urine, with or without blood cultures and antibiotic sensitivity testing are useful for establishing a formal diagnosis, and are considered mandatory. If a kidney stone is suspected, a kidneys, ureters, and bladder x-ray (KUB film) may assist in identifying radioopaque stones. Where available, a noncontrast helical CT scan with 5 millimeter sections is the diagnostic modality of choice in the radiographic evaluation of suspected nephrolithiasis. In patients with recurrent ascending urinary tract infections, it may be necessary to exclude an anatomical abnormality, such as vesicoureteral reflux or polycystic kidney disease. Investigations used in this setting include kidney ultrasonography or voiding cystourethrography. Ultrasound findings that indicate pyelonephritis are enlargement of the kidney, edema in the renal sinus or parenchyma, bleeding, loss of corticomedullary differentiation, abscess formation, or areas of poor blood flow on doppler ultrasound. A DMSA scan is a radionuclide scan that uses dimercaptosuccinic acid in assessing the kidney morphology. It is now the most reliable test for the diagnosis of acute pyelonephritis.

• #22 Acute pyelonephritis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/551

  Urinalysis and urine culture confirm the diagnosis of pyelonephritis. Urine cultures, obtained prior to treatment, demonstrate bacteria, most often Escherichia coli. […] 1st investigations to order: urinalysis, urine culture and sensitivity, full blood count, erythrocyte sedimentation rate, C-reactive protein, urea and electrolytes, creatinine, blood culture (in hospital). […] Diagnostic investigations include renal ultrasound, contrast-enhanced CT, and MRI.

• #23 Acute pyelonephritis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/551

  Urinalysis and urine culture confirm the diagnosis of pyelonephritis. Urine cultures, obtained prior to treatment, demonstrate bacteria, most often Escherichia coli. […] 1st investigations to order: urinalysis, urine culture and sensitivity, full blood count, erythrocyte sedimentation rate, C-reactive protein, urea and electrolytes, creatinine, blood culture (in hospital). […] Diagnostic investigations include renal ultrasound, contrast-enhanced CT, and MRI.

• #24 Acute Pyelonephritis Workup: Approach Considerations, Collection of Urine Specimens, Urinalysis

  https://emedicine.medscape.com/article/245559-workup

  Urine culture is indicated in any patient with pyelonephritis, whether treated in an inpatient or an outpatient setting, because of the possibility of antibiotic resistance. Reliable results require proper specimen collection. […] Blood cultures are indicated in any patient who is being admitted or who has already been admitted. Approximately 12-20% of patients have cultures that are positive for infection. Bacteremia has not been associated with a poor outcome unless sepsis or another significant comorbidity is present. […] Imaging may be required to make the diagnosis in infants and children in whom pyelonephritis presents insidiously. Imaging is warranted at the time of admission in patients with the following conditions: AIDS, poorly controlled diabetes, organ transplant (particularly kidney), other immunocompromised state, sepsis syndrome, septic shock.

• #25 Acute Pyelonephritis Workup: Approach Considerations, Collection of Urine Specimens, Urinalysis

  https://emedicine.medscape.com/article/245559-workup

  Urine culture is indicated in any patient with pyelonephritis, whether treated in an inpatient or an outpatient setting, because of the possibility of antibiotic resistance. Reliable results require proper specimen collection. […] Blood cultures are indicated in any patient who is being admitted or who has already been admitted. Approximately 12-20% of patients have cultures that are positive for infection. Bacteremia has not been associated with a poor outcome unless sepsis or another significant comorbidity is present. […] Imaging may be required to make the diagnosis in infants and children in whom pyelonephritis presents insidiously. Imaging is warranted at the time of admission in patients with the following conditions: AIDS, poorly controlled diabetes, organ transplant (particularly kidney), other immunocompromised state, sepsis syndrome, septic shock.

• #26 How a Kidney Infection Is Diagnosed

  https://www.everydayhealth.com/kidney-infection/diagnosis/

  If your doctor suspects a kidney infection at this point, you’ll be asked to give a urine sample for lab tests to look for a bacterial infection. […] You may also undergo imaging tests, which can look for enlargement or other abnormalities in your kidneys that indicate an infection. […] The most common lab tests to help diagnose a kidney infection are two types of urine test: Urinalysis and Urine Culture. […] In some cases, your doctor may order a blood test to look for signs of an infection. […] It’s usually unnecessary to order imaging tests to diagnose a kidney infection, according to the American Academy of Family Physicians. […] If your doctor believes that imaging tests are necessary, the following options are available: Computerized Tomography (CT) Scan, Magnetic Resonance Imaging (MRI), Ultrasound, Intravenous Pyelogram, and Voiding Cystourethrogram.

• #27 Acute Pyelonephritis Workup: Approach Considerations, Collection of Urine Specimens, Urinalysis

  https://emedicine.medscape.com/article/245559-workup

  Imaging early in the presentation of acute pyelonephritis may be more useful than previously thought. In one study, 16% of patients admitted for acute pyelonephritis were found to have new and clinically significant abnormalities on kidney imaging at the time of admission. […] Indications for imaging studies are as follows: fever or positive blood culture results that persist for longer than 48 hours, sudden worsening of the patients condition, toxicity persisting for longer than 72 hours, complicated urinary tract infection. […] Contrast-enhanced helical/spiral computed tomography (CECT) is the imaging study of choice, both in adults and in children with acute pyelonephritis. CECT is more sensitive than ultrasonography and intravenous pyelography (which has only 25% sensitivity), and it can more readily identify alterations in kidney parenchymal perfusion, alterations in contrast excretion, perinephric fluid, and nonrenal disease.

• #28 Diagnosis and Treatment of Acute Pyelonephritis in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0901/p519.html

  All patients with suspected acute pyelonephritis should have a urine culture and antimicrobial susceptibility testing to guide possible adjustment of the initial antimicrobial regimen (if there is no improvement) and selection of step-down oral therapy for patients treated initially with intravenous therapy. […] Most women with acute pyelonephritis do not need imaging studies unless symptoms do not improve or there is a recurrence. […] Blood cultures are commonly obtained from patients with acute pyelonephritis who are ill enough to warrant hospital admission, although they may not routinely be necessary in patients with uncomplicated acute pyelonephritis. Approximately 15 to 30 percent of patients with acute pyelonephritis are found to be bacteremic; older persons and those with complicated acute pyelonephritis are more likely to have bacteremia and sepsis.

• #29 Acute Pyelonephritis Workup: Approach Considerations, Collection of Urine Specimens, Urinalysis

  https://emedicine.medscape.com/article/245559-workup

  Imaging early in the presentation of acute pyelonephritis may be more useful than previously thought. In one study, 16% of patients admitted for acute pyelonephritis were found to have new and clinically significant abnormalities on kidney imaging at the time of admission. […] Indications for imaging studies are as follows: fever or positive blood culture results that persist for longer than 48 hours, sudden worsening of the patients condition, toxicity persisting for longer than 72 hours, complicated urinary tract infection. […] Contrast-enhanced helical/spiral computed tomography (CECT) is the imaging study of choice, both in adults and in children with acute pyelonephritis. CECT is more sensitive than ultrasonography and intravenous pyelography (which has only 25% sensitivity), and it can more readily identify alterations in kidney parenchymal perfusion, alterations in contrast excretion, perinephric fluid, and nonrenal disease.

• #30 Acute Pyelonephritis Workup: Approach Considerations, Collection of Urine Specimens, Urinalysis

  https://emedicine.medscape.com/article/245559-workup

  Magnetic resonance imaging (MRI) can detect kidney infection or masses and urinary obstruction, and it can evaluate the kidney vasculature. […] Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a sensitive biomarker for the diagnosis of acute pyelonephritis in children. […] Urinary concentrations of NGAL may also help identify children with acute pyelonephritis who are at increased risk of developing kidney scarring. […] Scintigraphy with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) is almost as sensitive clinically as contrast-enhanced helical/spiral computed tomography (CECT) in detecting focal kidney abnormalities during acute pyelonephritis in adults. […] In children, however, 99mTc-DMSA scintigraphy is the preferred study, because it involves less radiation exposure than CT scans.

• #31 Kidney Infection (Pyelonephritis): Symptoms & Treatment

  https://www.health.com/kidney-infection-overview-7498691

  Blood tests: This test helps to evaluate kidney function and assess for other markers of infection or inflammation. […] Imaging studies: This includes a computed tomography (CT) scan, ultrasound, and magnetic resonance imaging (MRI). These tests can provide a detailed view of the kidneys and urinary tract. […] In some cases, additional tests may be necessary to investigate specific conditions. For example, if urinary tract abnormalities or vesicoureteral reflux are suspected, a voiding cystourethrogram (VCUG) may be performed. This test involves injecting a contrast dye into the bladder and urethra and taking X-rays during urination.

• #32 Acute Pyelonephritis Workup: Approach Considerations, Collection of Urine Specimens, Urinalysis

  https://emedicine.medscape.com/article/245559-workup

  Imaging early in the presentation of acute pyelonephritis may be more useful than previously thought. In one study, 16% of patients admitted for acute pyelonephritis were found to have new and clinically significant abnormalities on kidney imaging at the time of admission. […] Indications for imaging studies are as follows: fever or positive blood culture results that persist for longer than 48 hours, sudden worsening of the patients condition, toxicity persisting for longer than 72 hours, complicated urinary tract infection. […] Contrast-enhanced helical/spiral computed tomography (CECT) is the imaging study of choice, both in adults and in children with acute pyelonephritis. CECT is more sensitive than ultrasonography and intravenous pyelography (which has only 25% sensitivity), and it can more readily identify alterations in kidney parenchymal perfusion, alterations in contrast excretion, perinephric fluid, and nonrenal disease.

• #33 Kidney Infections: Symptoms, Causes, Treatments, and Prevention

  https://www.webmd.com/a-to-z-guides/kidney-infections-symptoms-and-treatments

  Kidney Infection Diagnosis […] After asking about your symptoms, your doctor will probably do tests including: […] Urine analysis to look for bacteria in your pee. They’ll also look for white blood cells which your body makes to fight an infection. […] Urine culture to see what kind of bacteria you have. […] Your doctor may also use these tests: […] Ultrasound, MRI, or CT scan. These are imaging tests that let your doctor look inside your body to see if there is a blockage in your urinary tract. […] Voiding cystourethrogram. This is a type of X-ray to look for problems in your urethra and bladder when is full and when you are emptying it.

• #34 Pyelonephritis – Wikipedia

  https://en.wikipedia.org/wiki/Pyelonephritis

  Pyelonephritis is inflammation of the kidney, typically due to a bacterial infection. Symptoms most often include fever and flank tenderness. Other symptoms may include nausea, burning with urination, and frequent urination. Diagnosis is typically based on symptoms and supported by urinalysis. If there is no improvement with treatment, medical imaging may be recommended. Analysis of the urine may show signs of urinary tract infection. Specifically, the presence of nitrite and white blood cells on a urine test strip in patients with typical symptoms are sufficient for the diagnosis of pyelonephritis, and are an indication for empirical treatment. Blood tests such as a complete blood count may show neutrophilia. Microbiological culture of the urine, with or without blood cultures and antibiotic sensitivity testing are useful for establishing a formal diagnosis, and are considered mandatory. If a kidney stone is suspected, a kidneys, ureters, and bladder x-ray (KUB film) may assist in identifying radioopaque stones. Where available, a noncontrast helical CT scan with 5 millimeter sections is the diagnostic modality of choice in the radiographic evaluation of suspected nephrolithiasis. In patients with recurrent ascending urinary tract infections, it may be necessary to exclude an anatomical abnormality, such as vesicoureteral reflux or polycystic kidney disease. Investigations used in this setting include kidney ultrasonography or voiding cystourethrography. Ultrasound findings that indicate pyelonephritis are enlargement of the kidney, edema in the renal sinus or parenchyma, bleeding, loss of corticomedullary differentiation, abscess formation, or areas of poor blood flow on doppler ultrasound. A DMSA scan is a radionuclide scan that uses dimercaptosuccinic acid in assessing the kidney morphology. It is now the most reliable test for the diagnosis of acute pyelonephritis.

• #35 Signs of a Kidney Infection: When to Go to the Hospital

  https://www.verywellhealth.com/kidney-infection-when-to-go-to-the-hospital-7511488

  A kidney infection is mainly diagnosed with urine tests and imaging studies. The results of the tests will help direct the appropriate treatment. […] These include: Urinalysis: This is a chemical and microscopic evaluation of a urine sample to check signs of infection, including bacteria and defensive white blood cells. Urine culture: This is a lab procedure that grows bacteria from a sample of urine to determine the bacterial cause of your infection. Antimicrobial susceptibility testing: Bacteria identified by a urine culture are tested for their response to different antibiotics. Ultrasound: This is a noninvasive imaging tool that can visualize the size and structure of the kidneys using reflected sound waves. Computed tomography (CT): This is an imaging technology that composites multiple X-ray images to create three-dimensional (3D) views of internal organs. Magnetic resonance imaging (MRI): This imaging technology uses powerful magnetic and radio waves to create highly detailed images of soft tissues.

• #36 Acute Pyelonephritis Workup: Approach Considerations, Collection of Urine Specimens, Urinalysis

  https://emedicine.medscape.com/article/245559-workup

  Magnetic resonance imaging (MRI) can detect kidney infection or masses and urinary obstruction, and it can evaluate the kidney vasculature. […] Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a sensitive biomarker for the diagnosis of acute pyelonephritis in children. […] Urinary concentrations of NGAL may also help identify children with acute pyelonephritis who are at increased risk of developing kidney scarring. […] Scintigraphy with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) is almost as sensitive clinically as contrast-enhanced helical/spiral computed tomography (CECT) in detecting focal kidney abnormalities during acute pyelonephritis in adults. […] In children, however, 99mTc-DMSA scintigraphy is the preferred study, because it involves less radiation exposure than CT scans.

• #37 Signs of a Kidney Infection: When to Go to the Hospital

  https://www.verywellhealth.com/kidney-infection-when-to-go-to-the-hospital-7511488

  A kidney infection is mainly diagnosed with urine tests and imaging studies. The results of the tests will help direct the appropriate treatment. […] These include: Urinalysis: This is a chemical and microscopic evaluation of a urine sample to check signs of infection, including bacteria and defensive white blood cells. Urine culture: This is a lab procedure that grows bacteria from a sample of urine to determine the bacterial cause of your infection. Antimicrobial susceptibility testing: Bacteria identified by a urine culture are tested for their response to different antibiotics. Ultrasound: This is a noninvasive imaging tool that can visualize the size and structure of the kidneys using reflected sound waves. Computed tomography (CT): This is an imaging technology that composites multiple X-ray images to create three-dimensional (3D) views of internal organs. Magnetic resonance imaging (MRI): This imaging technology uses powerful magnetic and radio waves to create highly detailed images of soft tissues.

• #38 Pyelonephritis – Wikipedia

  https://en.wikipedia.org/wiki/Pyelonephritis

  Pyelonephritis is inflammation of the kidney, typically due to a bacterial infection. Symptoms most often include fever and flank tenderness. Other symptoms may include nausea, burning with urination, and frequent urination. Diagnosis is typically based on symptoms and supported by urinalysis. If there is no improvement with treatment, medical imaging may be recommended. Analysis of the urine may show signs of urinary tract infection. Specifically, the presence of nitrite and white blood cells on a urine test strip in patients with typical symptoms are sufficient for the diagnosis of pyelonephritis, and are an indication for empirical treatment. Blood tests such as a complete blood count may show neutrophilia. Microbiological culture of the urine, with or without blood cultures and antibiotic sensitivity testing are useful for establishing a formal diagnosis, and are considered mandatory. If a kidney stone is suspected, a kidneys, ureters, and bladder x-ray (KUB film) may assist in identifying radioopaque stones. Where available, a noncontrast helical CT scan with 5 millimeter sections is the diagnostic modality of choice in the radiographic evaluation of suspected nephrolithiasis. In patients with recurrent ascending urinary tract infections, it may be necessary to exclude an anatomical abnormality, such as vesicoureteral reflux or polycystic kidney disease. Investigations used in this setting include kidney ultrasonography or voiding cystourethrography. Ultrasound findings that indicate pyelonephritis are enlargement of the kidney, edema in the renal sinus or parenchyma, bleeding, loss of corticomedullary differentiation, abscess formation, or areas of poor blood flow on doppler ultrasound. A DMSA scan is a radionuclide scan that uses dimercaptosuccinic acid in assessing the kidney morphology. It is now the most reliable test for the diagnosis of acute pyelonephritis.

• #39 Acute Pyelonephritis Workup: Approach Considerations, Collection of Urine Specimens, Urinalysis

  https://emedicine.medscape.com/article/245559-workup

  Magnetic resonance imaging (MRI) can detect kidney infection or masses and urinary obstruction, and it can evaluate the kidney vasculature. […] Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a sensitive biomarker for the diagnosis of acute pyelonephritis in children. […] Urinary concentrations of NGAL may also help identify children with acute pyelonephritis who are at increased risk of developing kidney scarring. […] Scintigraphy with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) is almost as sensitive clinically as contrast-enhanced helical/spiral computed tomography (CECT) in detecting focal kidney abnormalities during acute pyelonephritis in adults. […] In children, however, 99mTc-DMSA scintigraphy is the preferred study, because it involves less radiation exposure than CT scans.

• #40 Kidney Infection (Pyelonephritis): Symptoms & Treatment

  https://www.health.com/kidney-infection-overview-7498691

  Blood tests: This test helps to evaluate kidney function and assess for other markers of infection or inflammation. […] Imaging studies: This includes a computed tomography (CT) scan, ultrasound, and magnetic resonance imaging (MRI). These tests can provide a detailed view of the kidneys and urinary tract. […] In some cases, additional tests may be necessary to investigate specific conditions. For example, if urinary tract abnormalities or vesicoureteral reflux are suspected, a voiding cystourethrogram (VCUG) may be performed. This test involves injecting a contrast dye into the bladder and urethra and taking X-rays during urination.

• #41 Acute Pyelonephritis Workup: Approach Considerations, Collection of Urine Specimens, Urinalysis

  https://emedicine.medscape.com/article/245559-workup

  Magnetic resonance imaging (MRI) can detect kidney infection or masses and urinary obstruction, and it can evaluate the kidney vasculature. […] Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a sensitive biomarker for the diagnosis of acute pyelonephritis in children. […] Urinary concentrations of NGAL may also help identify children with acute pyelonephritis who are at increased risk of developing kidney scarring. […] Scintigraphy with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) is almost as sensitive clinically as contrast-enhanced helical/spiral computed tomography (CECT) in detecting focal kidney abnormalities during acute pyelonephritis in adults. […] In children, however, 99mTc-DMSA scintigraphy is the preferred study, because it involves less radiation exposure than CT scans.

• #42 Inflammatory markers for improved recurrent UTI diagnosis in postmenopausal women | Life Science Alliance

  https://www.life-science-alliance.org/content/7/4/e202302323

  Accurate diagnosis of UTI remains a clinical challenge. Initial UTI diagnosis is based on symptoms, physical examination, and urinalysis. Urine culture (UC) is the gold standard to confirm UTI diagnosis but has a diagnostic window of 48-72 h. […] Inflammatory cytokines secreted as part of the immune response to infection have the potential to be useful diagnostic biomarkers. […] Therefore, the aim of this study was to investigate urinary cytokines as diagnostic markers for rUTI in postmenopausal women. […] We found that urinary concentrations of IL-1, IL-8, IL-18, MCP-1 are significantly elevated in women with active rUTI compared with controls. […] Using logistic regression analysis, we determined that a three-variable model consisting of IL-8, PGE2, and IL-13 reliably discriminated patients based on current UTI status. […] Our data indicate that overall, the PGE2, IL-8, IL-13 model had excellent sensitivity and specificity with the lowest misclassification rate for rUTI diagnosis in postmenopausal women.

• #43 Acute Pyelonephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519537/

  Acute pyelonephritis is a bacterial infection causing inflammation of the kidneys. Pyelonephritis is generally a complication of an ascending urinary tract infection that spreads from the bladder to the kidneys. […] Symptoms usually include fever, flank pain, nausea, vomiting, burning with urination, increased urinary frequency, and urgency. […] It is important to differentiate acute pyelonephritis, a medical condition treated primarily with antibiotics, from pyonephrosis (obstructive pyelonephritis), a clinically similar condition that requires urgent surgical drainage of an obstructed, infected renal pelvis. […] The role of imaging is discussed, and suggested empiric antibiotics are identified. This activity outlines the clinical presentation, diagnosis, and management of acute pyelonephritis and highlights the role of the interprofessional team in caring for patients with the condition.

• #44 Pyelonephritis (Kidney Infection) – AAUrology

  https://aaurology.com/men/pyelonephritis/

  Pyelonephritis is a type of urinary tract infection where one or both kidneys become infected with either bacteria, a virus, or a fungus. Bacterial infection is by far the most common. Patients with pyelonephritis often feel quite ill and require antibiotic treatment. […] Many other conditions in the abdomen and pelvis can cause symptoms that mimic a kidney infection. Your health care provider will want to diagnose this correctly so the proper treatment can be rendered. The following tests may be utilized: Medical history – your provider will ask a number of questions about your current condition and your past medical history, Physical exam – this will likely include an abdominal exam to assess for swelling and tenderness, Urinalysis – a sample of urine will be evaluated for evidence of infection, such as white blood cells and bacteria, Urine culture – a standard urine culture may be done. This is generally sent to a lab and requires approximately 3 days for results to return. It can also be negative in the face of infection, particularly if the patient has already taken an antibiotic, PCR (polymerase chain reaction) – this is a relative new test that uses DNA analysis to detect bacteria. It tends to be more sensitive than a standard culture and results generally take 1-2 days, Kidney ultrasound – an ultrasound examination will sometimes be performed to look for kidney abnormalities, particularly evidence of stones and/or obstruction. Ultrasound, however, can be completely normal in a patient with a kidney infection, CT (computerized tomography) – not usually needed to diagnosis a kidney infection, but like a sonogram, can be helpful to look for other issues such as stone and/or obstruction.

• #45 Signs of a Kidney Infection: When to Go to the Hospital

  https://www.verywellhealth.com/kidney-infection-when-to-go-to-the-hospital-7511488

  As part of the diagnosis, your healthcare provider may want to exclude other conditions that mimic the signs of a kidney infection. This helps ensure the correct treatment is given. […] A kidney infection can either be acute (sudden and severe) or chronic (persistent or recurrent). Both can cause serious complications if left untreated. […] Acute pyelonephritis is designated as either uncomplicated or complicated. Uncomplicated kidney infections can usually be treated at home, while complicated cases may require inpatient care in a hospital. […] Hospitalization may be needed if you have a severe kidney infection and you: Are an older adult, Are pregnant and have a fever or other illness, Have kidney stones or a urinary tract abnormality, Recently had urinary tract surgery, Have cancer, uncontrolled diabetes, neurogenic bladder, or other medical concerns, Failed antibiotic treatment at home. […] The prognosis for a kidney infection is generally good if the appropriate treatment is delivered in a timely manner. This is true even if a person develops acute kidney failure, the condition of which is usually reversible.

• #46 Diagnosis and Treatment of Acute Pyelonephritis in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0901/p519.html

  Acute pyelonephritis is a common bacterial infection of the renal pelvis and kidney most often seen in young adult women. History and physical examination are the most useful tools for diagnosis. Most patients have fever, although it may be absent early in the illness. Flank pain is nearly universal, and its absence should raise suspicion of an alternative diagnosis. A positive urinalysis confirms the diagnosis in patients with a compatible history and physical examination. Urine culture should be obtained in all patients to guide antibiotic therapy if the patient does not respond to initial empiric antibiotic regimens. […] A urine culture and antimicrobial susceptibility testing should be performed in women with suspected acute pyelonephritis. Initial empiric therapy should be selected based on the likely infecting uropathogen and local antibiotic sensitivity patterns.

• #47 Kidney infection | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/kidneys-bladder-and-prostate/kidney-infection/

  Diagnosing kidney infections requires your GP to ask about your symptoms and recent medical history. […] A urine test can help to establish whether you have a urinary tract infection (UTI). […] For your GP to be confident you have a kidney infection, you need to have a positive urine test plus certain symptoms, such as a fever or a pain in your side. […] Your GP can carry out some simple tests to help diagnose a kidney infection. […] You may be referred to hospital for further testing if your symptoms fail to respond to treatment with antibiotics. […] In these circumstances, scans can check your urinary tract for signs of problems. […] Most people with a kidney infection can be treated at home with a course of antibiotics, and possibly painkillers as well. […] If your symptoms show no sign of improvement 24 hours after treatment starts, contact your GP for advice.

• #48 Effective COPD Diagnosis and Treatment in Miami | Larkin Pulmonology

  https://larkinhealth.com/en/treatments-services/nephrology/kidney-infection/diagnosis-and-treatment/

  Diagnosing a kidney infection, also known as pyelonephritis, involves a combination of medical evaluation, patient history, physical examination, and diagnostic tests. Proper diagnosis is crucial for timely and accurate treatment. […] A urinalysis is one of the initial tests performed. It involves analyzing a urine sample to check for the presence of bacteria, white blood cells, red blood cells, and other indicators of infection. […] A urine culture may be ordered to identify the specific type of bacteria causing the infection. This information helps guide antibiotic treatment. […] Blood tests, such as a complete blood count (CBC) and a blood culture, may be done to assess the severity of the infection and its impact on your overall health. […] Imaging tests like ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) may be performed to visualize the kidneys and urinary tract for any abnormalities, obstructions, or signs of infection. […] Timely diagnosis is crucial to prevent complications. If a kidney infection is suspected, prompt treatment can help prevent the infection from worsening and causing further damage.

• #49 Kidney Infection vs. UTI: Symptoms, Causes, Diagnosis & More

  https://www.healthline.com/health/kidney-infection-vs-uti

  A kidney infection can share many symptoms with other types of UTIs. […] A kidney infection can lead to serious complications, including kidney damage or a life threatening condition called sepsis. […] If the doctor suspects that you have a kidney infection, they may order imaging tests, such as a CT scan of your abdomen and pelvis. […] Treatment for kidney infections generally lasts 7 to 14 days, depending on which class of antibiotic is prescribed. […] If you do have any symptoms of a UTI, its very important that you see a doctor. Getting a proper medical diagnosis and starting antibiotic treatment can help to prevent a potentially serious kidney infection.

• #50 Kidney Infection – Kidney and Urinary Tract Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/urinary-tract-infections-utis/kidney-infection

  Pyelonephritis is a bacterial infection of one or both kidneys. […] Urine and sometimes blood tests and imaging tests are done if doctors suspect pyelonephritis. […] The typical symptoms of pyelonephritis lead doctors to do 2 common laboratory tests to determine whether the kidneys are infected. […] Examination of a urine specimen under a microscope to count the number of red and white blood cells and bacteria. […] Urine culture, in which bacteria from a urine sample are grown in a laboratory to identify the numbers and types of bacteria. […] Blood tests may be done to check for elevated white blood cell levels (suggesting infection), bacteria in the blood, or kidney damage. […] Imaging tests are done in people who have intense back pain (typical of renal colic). […] Antibiotics are started as soon as the doctor suspects pyelonephritis and samples have been taken for laboratory tests. […] Antibiotic treatment of pyelonephritis is given for 5 to 14 days so that infection will not recur. […] A final urine sample is usually taken shortly after the antibiotic treatment is finished to make sure the infection has been eradicated. […] Most people recover fully.

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