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What is this?

It is a bacterial urinary tract infection of the renal parenchyma and excretory tract intra-renal.

It is common in women.

Contamination mechanism and germ involved:

There are two mechanisms of contamination:

  • The ascending pathway: Acute pyelonephritis occurs when germs rise from the bladder to the kidneys through the ureters. The germs involved are the same than for cystitis.
  • The hematogenous route: the kidney is infected by the germs carried by the blood during of sepsis. The most common germ involved is staphylococcus.

Symptoms:

Typically, the clinical picture associates signs of cystitis (voiding burns, urge to urinate and pollakiuria) with signs of renal parenchymal involvement:

fever, lower back pain radiating to the pubis and external genitalia.

Physical examination finds pain on palpation of the lumbar fossa.

Biology:

ECBU: positive

Biological inflammatory syndrome: leukocytosis, high CRP.

Radiology:

Renal ultrasound is essential in the search for pyelocalicular dilation posing thus the diagnosis of acute obstructive pyelonephritis.

Processing:

In the case of acute non-obstructive pyelonephritis, treatment is based on antibiotic therapy for 15 days associated with analgesic treatment and hyperdiuresis.

In obstructive forms the treatment is medico-surgical combining treatment antibiotic and urine drainage either by a double J catheter or by a percutaneous nephrostomy.