Pyelonephritis: treatments, when to go to the emergency room?

Pyelonephritis treatments when to go to the emergency room

Acute pyelonephritis is a kidney infection, one of the complications of poorly treated or treatment-resistant cystitis. What are the symptoms ? In the baby? How long for healing?

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 ? Lighting.

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), causing a kidney inflammation and infection within hours.

What are the symptoms of pyelonephritis?

Diagram of a kidney with pyelonephritis © designua – 123RF

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)
  • tachycardia (rapid heart rate)
  • diarrhea
  • vomitings
  • nausea
  • bloating

The pain can be spontaneous, or appear during palpation by the doctor. They can radiate under the ribs or descend towards the pubis.

► 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, symptoms are misleading and may be, depending on theHealth Insurance :

  • 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?

Pyelonephritis is especially common in young women. It is most often caused by poorly treated or treatment-resistant cystitis. A malformation of the urinary tract may also promote the phenomenon. Namely that the anatomical and physiological specificities of pregnancy increase the risk of developing pyelonephritis. However, other factors can cause pyelonephritis such as prolonged constipation.

The diagnosis of pyelonephritis is based on the clinical signs. The achievement ofa urinalysis using a reactive strip dipped in urine makes it possible to make the diagnosis. If the reactive part for the detection of white blood cells is positive, this indicates a urinary tract infection. If the part for nitrites is positive, this indicates the presence of bacteria. If one of these two elements is present, a Cyto-Bacteriological examination of Urine (or ECBU) is performed to confirm the presence of germs. Moreover, an ultrasound of the urinary tract is necessary within 24 hours, in case of first episode of pyelonephritis for the search for a factor favoring its appearance.

When to go to the emergency room for pyelonephritis?

As soon as symptoms appearit is essential to consult an emergency doctor to avoid any complications, which could lead to kidney failure”warns Doctor Handschuh. an ultrasound is usually performed to look for a possible obstacle or anatomical anomaly and to check the condition of the affected kidney. A blood test will also assess the severity of the infection.

What are the risks of complications from pyelonephritis?

Properly managed pyelonephritis usually evolves favorably. “If left untreated, pyelonephritis can cause the appearance ofa kidney abscess or generalized infection (sepsis)”, reports our expert. Sepsis can be fatal.

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. Rest and plenty of water are also necessary. 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. To prevent the appearance of cystitis, remember that it is advisable to:

  • drink at least 1.5 liters of water a day,
  • to wipe back and forth after urination (not the other way around!)
  • to urinate after each intercourse.

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 complicationsaccording to Health Insurance.

Thanks to Dr Richard Handschuh, general practitioner.

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