Pyelonephritis

Cause

An inflammation of the renal pelvis is in most cases caused by Escherichia coli, a bacterium which belongs in the large intestine. These bacteria enter the bladder via the urethra. From the bladder they end up, via the ureter, in the renal pelvis. After infection, it takes one to twelve days before the first symptoms occur. Sometimes, pyelonephritis is also caused by an improperly treated bladder infection or a kidney stone. In some cases, pyelonephritis is caused by tubercolosis or fungal infection.
The risk of pyelonephritis is increased in people with a blockage of the ureters, in case of diabetes mellitus, a poor immune system (making the body combat infections less properly) and in pregnant women.

Symptoms

Pyelonephritis is in symptoms similar to a bladder infection, but is more serious. In both cases, the urine is turbid, sometimes light red in color due to blood in the urine. The patient is in pain during peeing and often pees small quantities. In case of a pyelonephritis, a person generally feels a lot sicker than with a bladder infection. The patient has high fever, is sick and has chills. The patient can also have pain in the lower abdomen, back or side.
A distinction is made between acute and chronic pyelonephritis:

• In case of an acute pyelonephritis, a sudden and intense pain in the back or side, just above the waist, occurs in most cases. The pain is usually located at one side and slowly moves down in the direction of the groin. The patient often experiences fever with chills and nausea.
• With a chronic pyelonephritis, all these features are much less obvious. Often, the patient only suffers from fatigue and discomfort.

Diagnosis

In order to determine the diagnosis of pyelonephritis, two laboratory tests are carried out: microscopic examination of a urine sample and a bacterial culture in a urine sample to determine which bacteria are present. A blood test is done to determine whether the number of white blood cells has increased, or that the blood contains bacteria.

Treatment

Pyelonephritis doesn’t heal on its own. The general practitioner will, depending on the type of bacterium that causes the inflammation, prescribe a course of antibiotics. In addition, the patient can also use a painkiller. Surgery may be necessary if examination demonstrates that there are circumstances that increase the risk of infection, such as a blockage, structural defect or a stone.

Prognosis

Pyelonephritis rarely causes permanent damage. The kidneys usually recover completely. Incidentally, scar tissue remains in the kidney. This can lead to kidney failure.

Considerations

• The advice is to have rest and drink plenty of fluids until the fever has gone. Drinking a lot ensures that the bladder is to be emptied regularly, so bacteria quickly disappear from the bladder.
• In case of nausea, a person can better drink small amounts frequently, rather than a large glass at once. This way, one can keep it down easier.
• It is also important, not to postpone peeing when feeling urge, even though when it hurts. Pee the entire bladder empty. It’s best to pee one more time before bedtime.
• It is better not to use soap, sprays or vaginal douches at the underside of the body, so that the acidity of the vagina remains intact. Showers are better than baths.
• It is advisable not to wear synthetic underwear or strings. These are a major breeding ground for bacteria.

Facts

• The term ‘pyelonephritis’ is derived from the Latin word pyelum (renal pelvis) and the Greek word nephros (kidney). The suffix -itis indicates that it is an inflammation.
• The prevalence of pyelonephritis is unknown.
• Women are more likely to have this condition than men.