pyelonephritis

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Introduction

Inflammation/infection of the upper urinary tract. In adults, chronic pyelonephritis usually does not develop in the absence of a major underlying functional or structural anomaly.

Etiology

Epidemiology

  • short length & positioning of urethra makes females more susceptible to UTIs & pyelonephritis than men

Pathology

Clinical manifestations

Laboratory

Diagnostic procedures

Radiology

Complications

Differential diagnosis

Management

More general terms

More specific terms

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 542-43
  2. The Sanford Guide to Antimicrobial Therapy, 29th ed., Gilbert, DN et al (editors), Antimicrobial Therapy, Inc., Hyde Park VT, 1999
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 Medical Knowledge Self Assessment Program (MKSAP) 14, 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 2006, 2009, 2012, 2015, 2018, 2021.
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  4. 4.0 4.1 Sandberg T et al. Ciprofloxacin for 7 days versus 14 days in women with acute pyelonephritis: A randomised, open-label and double-blind, placebo-controlled, non-inferiority trial. Lancet 2012 Jun 21 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22726802 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60608-4/fulltext
    Nicolle LE. Minimum antimicrobial treatment for acute pyelonephritis. Lancet 2012 Jun 21 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22726803 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60770-3/fulltext
  5. Gupta K, Hooton TM, Naber KG, Wullt B et al International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011 Mar 1;52(5):e103-20 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21292654 (corresponding NGC guideline withdrawn Jan 2017)
  6. Johnson JR, Russo TA. Acute Pyelonephritis in Adults. N Engl J Med 2018; 378:48-59. January 4, 2018 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29298155 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcp1702758
    Rothaus C Acute Pyelonephritis. NEJM Resident 360. Jan 3, 2018 https://resident360.nejm.org/content_items/acute-pyelonephritis-in-adults
  7. 7.0 7.1 Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med 2012 Mar 16; 366:1028 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22417256
  8. Talan DA, Stamm WE, Hooton TM et al. Comparison of ciprofloxacin (7 days) and trimethoprim- sulfamethoxazole (14 days) for acute uncomplicated pyelonephritis in women: a randomized trial. JAMA 2000 Mar 29; 283:1583-90. PMID: https://www.ncbi.nlm.nih.gov/pubmed/10735395
  9. NEJM Knowledge+ Question of the Week. Jan 30, 2018 https://knowledgeplus.nejm.org/question-of-week/1569/
  10. NEJM Knowledge+ Question of the Week. June 25, 2019 https://knowledgeplus.nejm.org/question-of-week/610/
    Eloubeidi MA, Fowler VG. Images in clinical medicine. Emphysematous pyelonephritis. N Engl J Med 1999 Sep 2; 341:737 PMID: https://www.ncbi.nlm.nih.gov/pubmed/10471460 Free full text https://www.nejm.org/doi/full/10.1056/NEJM199909023411005
    Kawashima A, LeRoy AJ. Radiologic evaluation of patients with renal infections. Infect Dis Clin North Am 2003 Jun; 17:433. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12848478
    Nikolaidis P et al. American College of Radiology. ACR Appropriateness Criteria. acute pyelonephritis. https://acsearch.acr.org/docs/69489/Narrative/
  11. 11.0 11.1 11.2 Lee RA, Centor RM, Humphrey LL et al. Appropriate use of short-course antibiotics in common infections: Best practice advice from the American College of Physicians. Ann Intern Med 2021 Apr 6; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33819054 https://www.acpjournals.org/doi/10.7326/M20-7355
  12. 12.0 12.1 NEJM Knowledge+ Nephrology/Urology
  13. Pyelonephritis (Kidney Infection) in Adults http://kidney.niddk.nih.gov/kudiseases/pubs/pyelonephritis/index.htm

Patient information

pyelonephritis patient information