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People with acute pyelonephritis that is accompanied by high fever and leukocytosis are typically admitted to the hospital for intravenous hydration and intravenous antibiotic treatment. Treatment is typically initiated with an intravenous fluoroquinolone, an aminoglycoside, an extended-spectrum penicillin or cephalosporin, or a carbapenem ...
The most obvious cause is a kidney or systemic disorder, including amyloidosis, [2] polycystic kidney disease, [3] electrolyte imbalance, [4] [5] or some other kidney defect. [2] The major causes of acquired nephrogenic diabetes insipidus that produce clinical symptoms (e.g., polyuria) in the adult are lithium toxicity and high blood calcium.
Pyelonephritis occurs between 20 and 30 times less frequently. [4] They are the most common cause of hospital-acquired infections accounting for approximately 40%. [115] Rates of asymptomatic bacteria in the urine increase with age from two to seven percent in women of child-bearing age to as high as 50% in elderly women in care homes. [42]
Nitrofurantoin, trimethoprim-sulfamethoxazole (TMP/SMX), fosfomycin, and pivmecillinam are currently the first-line agents for empiric therapy of simple cystitis. [4] On the other hand, the choice of empiric antimicrobial therapy for pyelonephritis depends on the severity of illness, specific host factors , and the presence of resistant bacteria.
Acute kidney injury (AKI), previously called acute renal failure (ARF), [1] [2] is a sudden decrease in kidney function that develops within seven days, [3] as shown by an increase in serum creatinine or a decrease in urine output, or both.
Norepinephrine (Levophed) is the most common first-line vasopressor for people who don't respond well to other hypotension treatments such as fluid resuscitation. Atropine is administered for bradycardia. It acts on the vagus nerve so it's not effective in heart transplant patients as the vagus nerve is severed during the transplant.
Emergency treatment is not needed if the person is asymptomatic or minimally symptomatic. [34] Treatment of chronic symptomatic bradycardia first necessitates correlation of symptoms. [5] Once symptoms have been clearly linked to bradycardia, permanent cardiac pacing can be provided to increase heart rate and symptoms will improve. [5]
Together with intravenous antibiotics, drainage [8] —either percutaneous or retrograde with a ureteral stent [9] —has become the cornerstone of treatment since the development of ultrasonography and computed tomography (CT) scanning. Drainage offers a great outcome with low rates of morbidity and mortality.