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Pyelonephrit
is
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Is a bacterial infection causinginammation of the renal pelvis,
tubules, and interstitial tissue ofone or both kidneys.
Pyelonephritis: Defnition:
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1. Common cause is the infection of the bacteria E. coli
2. May also be caused by candidiasis.
3. May be acute
!sually enlarged kidney, maybe abscesses, and possibly destruction of glomeruli.
". May be chronic
#idneys scarred, contracted, $ nonfunctioning
Pyelonephritis: Causes:
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mechanismsof bacterialinfection inpyelonephritis
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Causes incidence, andrisk actors• %he risk is increased if there is a history
o : cystitis.
renal papillary necrosis.
kidney stones.
vesicoureteric reu& or obstructive uropathy.
• Acute pyelonephritis can be severe inthe elderly and in people 'ho areimmunosuppressed (for e&le, those
'ith cancer or )I*+.
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1. Acute uncomplicated
pyelonephritis.
2. Chronic pyelonephritis
Pyelonephritis: Classication:
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– Infammatory disorder
– Renal tubules, interstitium, calcyces,and pelvis
– Inection may be present
– Combination o Chronic TIN,inection, stasis, obstruction, stone
ormation
– Acute pyelonephritis• Acute pyogenic infection o kidney
• Usually -. Coli and other fecal ora
– Chronic pyelonephritis
• Persistent or recurring episodes oacute pyelonephritis that lead toscarring
• Reux nephropathy most re!uentFigure from: Huether, Understanding Pathophysiology, 5th ed.,
Elsevier, 2012
Acute
Chronic
Pyelonephritis: Dierences an similarities :
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1. lank pain or back pain.
2. +evere abdominal pain
3. high fever and persists for more than 2
days.". Chills 'ith shaking.b/arm, ushed,
moist skin.
0. omiting, nausea.
. atigue and general ill feeling.
. 4ainful urination, urinary fre5uency orurgency nocturia.,
6. Cloudy or abnormal urine color, foul orstrong urine odor, and hematuria mayoccur.
7. Mental changes of confusion
Pyelonephritis:!ymptoms:
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anos c s u es
•
) urinalysis commonlyreveals 'hite blood cells(/8Cs or red blood cells(98Cs.
• ) urine culture may reveal
bacteria in the urine.
• ) blood culture may sho' aninfection.
•
)n intravenous pyelogram(I4 or C% scan of theabdomen may sho'enlarged kidneys 'ith pooro' of dye through the
kidneys.
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!reatment • !he oals o treatment are
control o the inection andreduction o symptoms.
• )cute symptoms usuallyresolve 'ithin "6 to 2 afterappropriate treatment.
• Intravenous (I antibioticsmay be used initially tocontrol the bacterial infectionif infection is severe a 1:; to
1" day course of antibioticschronic pyelonephritis.
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Antibiotic therapy
•
Antibiotics usein the treatmentofpyelonephritis:
•
Ciprofo#acin $%%mg every &' hoursor &( days)
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• Recurrence o pyelonephritis)
• Perinephric abscess inection
around the kidney")• *epsis )
• +cute renal ailure)
• Chronic renal ailure)
Complications: