Acute pyelonephritis is a kidney infection that occurs suddenly. Infection and the resulting inflammation mainly affect on the supportive tissue in which tiny filters, glomerulus, are located.
In some cases, the infection is caused by the action of microbes that came into the kidneys via bloodstream from another part of the body. However, in most cases, microbes comes from the skin around the urethra opening. If women do not pay attention to the hygiene of that part of the body, especially when they are wiping their anus after the defecation, bacteriae can enter the urinary tract and spread into the bladder and kidneys.
This is even more likely to happen if, for any reason, the normal flow of urine is clogged, because bacteria are propagated in stagnant urine and cannot be excreted normally as with unhindered flow. However, infections sometimes appear for no apparent reason in a otherwise healthy person.
In most cases, the disease is suddenly manifested by sudden strong back pain, immediately above the waist. Although both kidneys may be affected, the pains are usually stronger on one side, and the pain spreads on that side. The temperature rises abruptly, often up to 40 °C, and the patient can have a chill and shiver. Nausea and vomiting are possible, as well as dysuria (difficult or painful urination), and the feeling of constant need for urination, even though the urinary bladder is empty. Urine usually contains traces of blood and is therefore blurred or, sometimes, light-colored.
Acute pyelonephritis is a common infection in all age groups; on average, the doctor treats about one person out of 250 for this problem annually. It is four times more often in women, since the urethra (urinary tube) – the ”entrance” for bacteriae – is much shorter in women.
Some conditions that affect the free flow of urine also increase susceptibility to infection, e.g. pregnancy (as the pressure of the enlarged uterus on the ureter decreases urine flow), kidney stones, bladder tumor or, in the case of a man, enlarged prostate.
If the treatment starts immediately, the likelihood that complications will occur is really small. In small children or very weak persons, the infections can sometimes spread to the blood and cause blood poisoning. Repeated attacks may be a sign of some basic urinary tract deficiency that needs to be corrected.
What to do?
If you have symptoms of pyelonephritis, contact your doctor. In many cases, antibiotics and resting in the bed will suffice, and the seizure will ease after a day or two. However, after recovery, your doctor will probably refer you to the blood and urine tests, and possibly the special X-ray of the kidney – the intravenous pyelogram, and the bladder examination – cystoscopy.
In healthy adults, such diagnostic tests are rarely needed after a single seizure of acute pyelonephritis. However, if it is not the first seizure, and/or if the patient is a child, the doctor will recommend tests to find a possible basic problem and thus prevent permanent kidney damage.
Acute pyelonephritis is treated with resting in bed and light nutrition with additional amount of fluid (fruit juices or water). A doctor will also prescribe antibiotics that needs to be taken orally. In some cases – in children and the elderly, for example – the patient will have to go to the hospital to get food and medication by intravenous infusion. With antibiotics, the infection will be under control in 24 to 48 hours, though the treatment may last a little longer, but usually no more than ten days.