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Pyelonephritis is inflammation of the kidney, typically due to a bacterial infection. [3] Symptoms most often include fever and flank tenderness. [2] Other symptoms may include nausea, burning with urination, and frequent urination. [2] Complications may include pus around the kidney, sepsis, or kidney failure. [3]
When patients do not improve quickly with appropriate antibiotics, however, appropriate radiographic studies help diagnose pyonephrosis, emphysematous pyelonephritis, and renal and/or perirenal abscesses. [7]
Symptoms of a kidney infection, on the other hand, are more systemic and include fever or flank pain usually in addition to the symptoms of a lower UTI. [10] Rarely, the urine may appear bloody. [7] Symptoms may be vague or non-specific at the extremities of age (i.e. in patients who are very young or old). [1] [11]
CVA tenderness is often present in acute pyelonephritis. [ 5 ] [ 4 ] [ 6 ] [ 7 ] CVA tenderness may be present in patients who have a kidney stone , [ 8 ] [ 7 ] a stone in the ureter , [ 8 ] a ureteropelvic junction obstruction, [ 8 ] a kidney abscess , [ 8 ] a urinary tract infection , [ 9 ] and vesicoureteral reflux . [ 10 ]
Pyelonephritis is inflammation that results from a urinary tract infection that reaches the renal pelvis of the kidney. [6] Lupus nephritis is inflammation of the kidney caused by systemic lupus erythematosus (SLE), a disease of the immune system. [7] Athletic nephritis is nephritis resulting from strenuous exercise. [8]
This constellation of symptoms contrasts with the classical presentation of nephrotic syndrome (excessive proteinuria >3.5 g/day, low plasma albumin levels (hypoalbuminemia) <3 g/L, generalized edema, and hyperlipidemia). [8] [10] Signs and symptoms that are consistent with nephritic syndrome include: Hematuria (red blood cells in the urine) [11]
Murphy's sign has a high sensitivity and negative predictive value, although the specificity is not high. [2] However, in the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.
For acute cystitis and pyelonephritis in pregnant women, empiric antibiotic treatment is often initiated. Commonly used antibiotics for uncomplicated cystitis include amoxicillin-clavulanate and fosfomycin, while parenteral beta-lactams are preferred for acute pyelonephritis. These options are chosen because they are considered safer in ...