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Acute Pyelonephritis In Adults

Signs & Symptoms

 Flank pain
Note: Is often lacking in early or mild disease
Ref: Epocrates [ Acute pyelonephritis in adults]
Back pain
Note: Is often lacking in early or mild disease
Ref: Epocrates [ Acute pyelonephritis in adults]
Fever
Ref: Uptodate [ Acute complicated urinary tract infection (including pyelonephritis) in adults] Epocrates [ Acute pyelonephritis in adults]
Chills
Ref: Uptodate [ Acute complicated urinary tract infection (including pyelonephritis) in adults] Epocrates [ Acute pyelonephritis in adults]

Physical Examination

 Costovertebral angle tenderness
Note: Is often lacking in early or mild disease
Ref: Epocrates [ Acute pyelonephritis in adults]
Tender prostate (negative symptom) Gr. Male
Ref: Epocrates [ Acute pyelonephritis in adults]
Change in functional status
Ref: Uptodate [ Acute complicated urinary tract infection (including pyelonephritis) in adults]

Lab / Serology

 WBC casts
Note: noteSuggest a renal origin for the pyuria
Ref: Uptodate [ Acute complicated urinary tract infection (including pyelonephritis) in adults] Epocrates [ Acute pyelonephritis in adults]
Kidney Calculus
Ref: Epocrates [ Acute pyelonephritis in adults]
Renal stone
Ref: Epocrates [ Acute pyelonephritis in adults]

Imagin Study

 Kidney stones
Note: Diagnosis by sonography
Ref: Epocrates [ Acute pyelonephritis in adults]
Perirenal fluid collections
Note: noteDiagnosis by sonography
Ref: Epocrates [ Acute pyelonephritis in adults]
Urinary Obstruction
Note: Diagnosis by MRI
Ref: Epocrates [ Acute pyelonephritis in adults]

Complication

 Tachypnea
Note: Suggesting sepsis
Ref: Epocrates [ Acute pyelonephritis in adults]
Shock
Ref: Uptodate [ Acute complicated urinary tract infection (including pyelonephritis) in adults]
Multiple organ system dysfunction
Ref: Uptodate [ Acute complicated urinary tract infection (including pyelonephritis) in adults]

Risk Factors

 Age > 60
Ref: Epocrates [ Acute pyelonephritis in adults]
Age between 18 and 50
Ref: Epocrates [ Acute pyelonephritis in adults]
Female
Ref: Epocrates [ Acute pyelonephritis in adults]

Cause

 Impaired cytokine secretion
Note: due to Greater adherence of uropathogenic E coli to uroepithelial cells
Ref: Epocrates [ Acute pyelonephritis in adults]
Reduced polymorphonuclear inflammatory response
Note: due to Greater adherence of uropathogenic E coli to uroepithelial cells
Ref: Epocrates [ Acute pyelonephritis in adults]
Seeding of the kidneys
Note: due to Bacteremia in the lymphatics, due to entrance of bacteria in the lymphatics
Ref: Uptodate [ Acute complicated urinary tract infection (including pyelonephritis) in adults]

Other