Pyelonephritis

Alternative names:

acute pyelonephritis; complicated urinary tract infection; infection of the kidney; kidney infection; urinary tract infection - complicated

Symptoms:

• flank pain or back pain
• severe abdominal pain (occurs occasionally)
• fever
  • higher than 102 degrees Fahrenheit
  • persists for more than 2 days

• chills with shaking
• warm skin
• flushed or reddened skin
• moist skin (diaphoresis)
• vomiting, nausea
• fatigue
• general ill feeling
• urination, painful
• urinary frequency/urgency, increased
• need to urinate at night (nocturia)
• cloudy or abnormal urine color
• blood in the urine
• foul or strong urine odor
• mental changes or confusion *

* Often in the elderly person, mental changes or confusion are the only signs of a possible urinary tract infection.

Signs and tests:

An examination may show tenderness on palpation (pressing) over the kidney.

• A urinalysis commonly reveals white blood cells (WBC) and/or red blood cells (RBC).
• A urine culture (clean catch) or urine culture (catheterized specimen) may reveal bacteria in the urine.
• A blood culture may show an infection with gram-negative organisms.
• An IVP or CT scan of the abdomen may show enlarged kidney(s) with decreased excretion of contrast. (IVP and CT scan of the abdomen can also indicate underlying disorders.)

Underlying disorders predisposing a patient to acute pyelonephritis may be discovered by other tests and procedures, including:

• voiding cystourethrogram
• renal ultrasound
• renal scan
• renal biopsy