Pyelonephritis is an infection of the kidney caused by bacteria, most often of the Escherichia Coli type. It is the dreaded complication during a urinary tract infection (cystitis).
Pyelonephritis is acute infection of the kidney by bacteria, most often of the type Escherichia Coli coming from the bladder. It is often the complication of a urinary tract infection (cystitis) untreated or poorly treated, resistant to treatment, which thus goes up to the kidney. If the infection is more severe, hospitalization is necessary, especially if the pyelonephritis is obstructive and prevents urine excretion. What are the symptoms pyelonephritis? What is the cause ? What is the healing time pyelonephritis? What treatments? When to go to emergency room ? We take stock.
Definition: what is pyelonephritis?
Pyelonephritis is caused by bacteria present in the urine, most commonly from E. Coli typewhich goes up through the urinary tract to the kidney (we speak of ascending pyelonephritis). “This causes a b within hours, pyelonephritis“says Dr. Nadia Abid, urological surgeon.
What are the symptoms of pyelonephritis?
Symptoms of pyelonephritis appear suddenly.
► Symptoms in adults:
- high fever (above 38.5°C)
- chills
- pain in the lumbar fossae,one side only
- of the abdominal pain.
- urinary disorders (burning during urination, more frequent cravings or, on the contrary, anuria in the event of an obstacle, blood in the urine)
- tachycardia (rapid heartbeat)
- diarrhea
- vomitings
- nausea
- bloating
- chills
► Symptoms in the elderly:
Symptoms of acute pyelonephritis are often different in the elderly, including. the general condition deteriorates suddenly with:
- confusions
- disturbances in mental functions
- abdominal pain
- sometimes fever
- a great weakness
- a pallor
What are the symptoms of pyelonephritis in babies?
► Symptoms in young children. The symptoms of the child are identical to those of the adult. In babies or toddlers, the symptoms may be:
- an unexplained fever
- crying while urinating
- unusually colored or smelly urine and the presence of blood in the urine
- loss of appetite, bottle refusal,
- vomiting, diarrhea, abdominal pain;
- mood swings and fatigue, irritability, whining
- weight loss.
What are the possible causes of pyelonephritis?
There are several causes for the risk of developing pyelonephritis:
► “A deformity like junction syndrome which cause poor evacuation of urine which stagnates and can end up becoming infected, it can be present in children” indicates the urological surgeon.
► The recurrent cystitis (lower urinary tract infections) which mainly affect women because their urethra is shorter and closer to the anus. “The factors contributing to cystitis are: not drinking enough, not regularly emptying your bladder and especially after sexual intercourse (local irritation promotes the rise of germs), constipation, contraception, change in PH and hormonal phases“explains Dr. Abad. Cystitis, in the case of aggressive germs such as E. Coli, can cause urine to rise towards the kidneys and cause pyelonephritis.
► The infectious kidney stones which have germs can be a source of pyelonephritis if they pass in the urine, hence the importance of removing all kidney stones.
► Pregnancy, menopause and diabetes are contributing factors because the vaginal dryness increases local irritation.
► In man, we are looking for a cause of reflux or calculation “but pyelonephritis is very rare in them“ remarks our expert.
The diagnosis of pyelonephritis is based on the clinical signs. The achievement ofa urinalysis using a test strip dipped in urine makes it possible to make the diagnosis (ECBU) if there is an infection it will be positive for leukocytes and nitrites. “The ECBU informs us about the germ responsible for the infection and the sensitive antibiotics. We will do retrograde cystography (UCRM) to see if the urine goes up in the kidneys: the bladder is filled with contrast product and X-rays are taken to see if the urine has gone up. Often we realize kidney ultrasound or CT scan to rule out obstructive pyelonephritis because if there is a phenomenon of stagnation of urine in the kidney, the antibiotics will not work and the kidney will fill with pus. At this point, it will have to be drained“explains the urological surgeon.
When to go to the emergency room for pyelonephritis?
“As soon as symptoms appearand especially in case of feverit is necessary to consult quickly”warns Dr. Abid.
What are the risks of complications from pyelonephritis?
Properly managed pyelonephritis usually evolves favorably. “Above all, do not self-medicate.” warns our interlocutor. “As pyelonephritis affects kidney tissue, the risk of sequelae lies in small local scars that impair kidney function. If you are affected by repeated pyelonephritis, you risk kidney failure. It is also possible that the infection causes a kidney abscess if the pyelonephritis is taking too long to be taken care of. We can also see pyonephrosis (purulent kidney infection) which may require kidney removal“explains Dr. Abid.
What is the treatment to cure pyelonephritis?
The standard treatment for pyelonephritis (bacterial infection) consists of antibiotics (cephalosporins or fluoroquinolones) to fight the bacteria andanalgesics to reduce pain. The necessary rest will involve a fortnight’s work stoppage. Drinking plenty of water is also essential. The treatment lasts between 1 week and 10 days depending on the antibiotics. If the infection is more severe, hospitalization is necessary, especially if the pyelonephritis is obstructive and prevents urine excretion. In this case, it is urgent to perform urine drainage.
► He don’t hold back to go to the toilet”what is normal is to go to the toilet 6/7 times a day”.
► Urinate after sex
► Drink lots of water
► Avoid over-washing the private parts, the vaginal flora that protects against infections regenerates itself. Soaps that are too aggressive can destroy it. We never wash the inside of the vagina, only the outside.
► The position in the toilet : it is better to sit because the standing position prevents you from emptying your bladder well with a risk of urine going into the vagina. In addition, standing involves straining to urinate and this increases the risk of organ descent.
What is the healing time for pyelonephritis?
A pyelonephritis is cured thanks to the antibiotic treatment adapted to the germ, taken at the prescribed dose and for the entire duration indicated by the doctor. This treatment should be taken 7 to 10 days within simple acute pyelonephritis and for 10 days in the pyelonephritis at risk of complications.
Thanks to Dr. Nadia Abid, urological surgeon.