Introduction:

Acute upper urinary tract infection, commonly known as pyelonephritis, is a serious and potentially life-threatening condition that involves the kidneys, typically resulting from a lower urinary tract infection that has ascended to the renal pelvis and parenchyma. It requires prompt medical attention to prevent chronic kidney disease and other complications. This article explores the etiology, clinical features, diagnostic criteria, and management strategies for acute pyelonephritis.

Causes of Acute Upper Urinary Tract Infection (Pyelonephritis):

• Bacterial Infection: Most often caused by Escherichia coli (E. coli), but other bacteria can also be responsible.
• Urinary Tract Obstruction: Kidney stones, strictures, or other obstructions that impede urine flow can increase the risk.
• Vesicoureteral Reflux: A condition where urine flows backward from the bladder to the kidneys.
• Catheter Use: Long-term use of urinary catheters can introduce bacteria into the urinary tract.
• Compromised Immune System: Individuals with weakened immune systems are at higher risk.

Symptoms of Acute Upper Urinary Tract Infection (Pyelonephritis):

• Flank Pain: Pain or tenderness in the back or side, below the ribs, near the kidneys.
• High Fever: Often accompanied by shaking chills and sweating.
• Nausea and Vomiting: Gastrointestinal upset can accompany the infection.
• Frequent, Painful Urination: Similar to lower UTIs, with an urgent need to urinate.
• Cloudy or Bloody Urine: May have a strong odor.
• General Malaise: Feeling unwell, fatigued, or weak.

Diagnosis of Acute Upper Urinary Tract Infection (Pyelonephritis):

• Medical History and Symptoms: A thorough review of symptoms and medical history, including any recent UTIs or catheter use.
• Urinalysis: To look for white blood cells, red blood cells, bacteria, and to assess for the presence of nitrites and leukocyte esterase.
• Urine Culture: To identify the specific bacteria causing the infection and determine antibiotic sensitivity.
• Blood Tests: Complete blood count (CBC) and blood cultures may be performed to check for signs of infection and its spread.
• Imaging: Ultrasound or CT scans can be used to identify any obstructions or abnormalities in the urinary tract.

Treatment of Acute Upper Urinary Tract Infection (Pyelonephritis):

• Antibiotics: The mainstay of treatment, typically initiated with broad-spectrum antibiotics, which are then tailored based on culture results.
• Hospitalization: Severe cases may require hospital admission for intravenous antibiotics and fluids.
• Pain Management: Analgesics can be used to relieve flank pain and discomfort.
• Hydration: Adequate fluid intake is important to help flush out the urinary system.
• Follow-Up: Repeat cultures and imaging may be necessary to ensure the infection has resolved, especially in recurrent cases.

Conclusion:

Acute pyelonephritis is a severe form of UTI that demands immediate medical intervention to prevent serious health consequences. With timely and appropriate antibiotic therapy, most individuals recover without lasting effects. However, it's crucial to address any underlying risk factors to prevent recurrence.

Hashtags: #Pyelonephritis #UTI #KidneyInfection #AcuteUTI