Acute pyelonephritis is a serious infection of the kidneys, often starting as a lower urinary tract infection that travels upwards. It commonly affects women and can cause severe flank pain, fever, and nausea. Prompt diagnosis and treatment are crucial to prevent kidney damage and serious complications like sepsis.
Acute pyelonephritis is an ascending bacterial infection of the renal parenchyma and pelvis, typically caused by gram-negative bacilli, most commonly E. coli. It presents as a febrile urinary tract infection and can lead to renal abscess, sepsis, and chronic kidney disease if inadequately treated.
| Condition | Distinguishing Feature |
|---|---|
| Acute Cholecystitis | Right upper quadrant pain, often associated with meals, positive Murphy's sign, and elevated liver enzymes. |
| Nephrolithiasis (Kidney Stones) | Colicky flank pain radiating to the groin, hematuria, and often absence of fever unless complicated by infection. |
| Appendicitis | Periumbilical pain migrating to the right lower quadrant, anorexia, and rebound tenderness. |
| Pneumonia | Pulmonary symptoms (cough, dyspnea, pleuritic chest pain), and abnormal lung auscultation findings. |
| Musculoskeletal Pain | Pain localized to the back or flank without systemic signs of infection or urinary symptoms, often reproducible with palpation of muscles or spine. |
| Pelvic Inflammatory Disease (PID) | Lower abdominal pain, vaginal discharge, cervical motion tenderness, and fever, typically in sexually active women. |
Management involves prompt initiation of empirical antibiotic therapy targeting common uropathogens, with adjustments based on urine culture results. Hospitalization is indicated for patients with severe symptoms, signs of sepsis, inability to tolerate oral intake, or underlying risk factors. Adequate hydration and pain management are crucial supportive measures.