Acute pyelonephritis (urinary tract infection) - causes, symptoms & pathology
Вставка
- Опубліковано 27 лис 2024
- What is acute pyelonephritis? Acute pyelonephritis is a type of upper urinary tract infection where bacteria infiltrate and infect the kidneys. Find our full video library only on Osmosis: osms.it/more.
Join millions of current and future clinicians who learn by Osmosis, along with hundreds of universities around the world who partner with Osmosis from Elseiver to make medical and health education more engaging and efficient. We have unparalleled tools and materials to prepare you for success in school, on your board exams, and as a future clinician. Sign up for a free trial at osms.it/more. If you're interested in exploring an institutional partnership, visit osmosis.org/educators to request a personalized demo.
Follow us on social:
Facebook: osms.it/facebook
Twitter: osms.it/twitter
Instagram for med: osms.it/instagram
Instagram for nursing: osms.it/ignursing
TikTok: osms.it/tiktok
Linkedin: osms.it/linkedin
Our Vision: Everyone who cares for someone will learn by Osmosis.
Our Mission: To empower the world’s clinicians and caregivers with the best learning experience possible. Learn more here: osms.it/mission
Medical disclaimer: Osmosis from Elsevier does not provide medical advice. Osmosis from Elsevier and the content available on the Osmosis from Elsevier properties (Osmosis.org, UA-cam, and other channels) do not provide a diagnosis or other recommendation for treatment and are not a substitute for the professional judgment of a healthcare professional in diagnosis and treatment of any person or animal. The determination of the need for medical services and the types of healthcare to be provided to a patient are decisions that should be made only by a physician or other licensed healthcare provider. Always seek the advice of a physician or other qualified healthcare professional with any questions you have regarding a medical condition.
© 2024 Elsevier. All rights reserved.
Was diagnosed with a UTI 8 days ago. They gave me standard antibiotics and I became worse. Went to hospital 4 days later and they diagnosed me with pyelonephritis and said the original antibiotics were useless against this infection. 4 days days after this, I was hospitalised again with worsening pain in my flank and the doctors said my urine culture came back and the antibiotics they originally gave me were actually not going to work for what I have- acute pyelonephritis. Let’s hope third time is a charm 😊
Haha same experience for me. I guess it’s common, because for them it’s hard to know whether it could be caused by STI as well, so they give smth generic in the beginning. Just my guess
me too, I was diagnosed with UTI afer a nephrolethiasis operation, it came back several times and I tooke 3 different kinds of antibiotics, I'm suffering right now, I wish I can soleve it
I'm an audiovisual study type, and this really helps me with My study. thank you so much!!
I have suffered UTI critically for 11years , all promise for cure are lies. I finally got cured with herbs medicine I purchased from Dr Oyalo channel and now I’m completely cured.
Thank you for sharing this I have had this over the last few days and just been discharged from hospital, This has explained it very well .
0:29 UTI (upper/lower) vs. pyelonephritis; 1:20 UVR; 4:28 summary
I was just diagnose today and i can tell you it is very painful . I was very curious as to what causes it and you're video shine light on that for me. Very informative!! Thank you!
How are you now? Have you cured it successfully yet? My sister recently got diagnosed with that too.
I just got out of the hospital yesterday and it was one of the worst pain I ever had the side and back pain hurt like hell
@@dariuscao1481 Yeah. as i remember, i was in quite a bit of pain for a couple of weeks. The meds did help, although i cant remember the name. I hope she is better....
@@ariannarivera8254 Yes sir, very painful!
you guys are the best! i'm a 3rd year med student and your videos help me A LOT! thank you so much! fave channel :)
great... where are you from? and What is the name of your university where you study?
TheMse09
Thank You For Your Awesome Thorough Explanation - Covering All Possible Causes and Symptoms of Chronic Pyelonephritis
Explaining the Ascending Bacteria that
Can Possibly Trigger
A Urinary Tract Infection
That Can Possibly Result In
A Kidney Infection-
This Video Helped me to
Explain My Symptoms
To My Doctor.
Thanks For The Info
I have suffered UTI critically for 11years , all promise for cure are lies. I finally got cured with herbs medicine I purchased from Dr Oyalo channel and now I’m completely cured.
This happened to my 72-year-old mother which took her out because she was too stubborn to go to the doctor so she had internal bleeding and all her organs shut down and this was on Christmas 2021 😞 rip mom I love you❤
Sorry for your loss, Kelly 🙏🏼
I won't be able to complete my MBBS without your videos thank u so much osmosis!
I love your videos. Very informative and fun to watch. You are not only helping out MDs, but PAs as well
Thanks for posting these vids! really appreciate them; and to the prior poster, humanity does not focus on greed, but the betterment and contribution to your fellow man
Thank for tuning in Hakimoto!
I have suffered UTI critically for 11years , all promise for cure are lies. I finally got cured with herbs medicine I purchased from Dr Oyalo channel and now I’m completely cured.
Dear Osmosis crew, I read in my textbook that the reflux of urine is mittigated by a physiological system rather than a valve: due to the low/more horizontal implantation of the ureters, the ureter can't be compressed by the bladder wall when the bladder is full
You are right 👍
Please specify which antibiotics to use for each bacteria. Awesome video
thank you...the method of teaching is excellent.... & helpful. .. thank you again
so much lucky to find this channel .... may God bless you
please, when you say "treatment with antibiotics", please stress the start of generic treatment before the culture-tests are back. ty. Love your videos :)
We focus on pathology content, not treatment in our videos. When we start creating treatment and/or pharmacology videos we'll look at specific treatment methods in more detail!
Iam a medical student
I study genital Urinary system
I love your videos
Thanks alot
I hope to meet you guys on person
Mujtaba abdulraheem alhamdulillah
Well that cut down my study time quite a bit, thank you for that.
Right in time. I am studying nephrology right now. Thank you for the videos! (Btw: can you make some new neurology videos as well?)
more videos on renal please!!
Or maybe surgical procedures. Would be awesome! ;) (like placement of an external ventricular drain, circumplast/plastibell; including complications, indication, technique, preop. and postop. care,...) :D
Right now we're only focusing on pathology videos. We'll make more renal videos eventually! You can vote for upcoming videos by becoming a Patreon subscriber. www.patreon.com/osmosis
I have suffered UTI critically for 11years , all promise for cure are lies. I finally got cured with herbs medicine I purchased from Dr Oyalo channel and now I’m completely cured.
I like his explanation ,along with the animation his voice is really 👌
Thanks! ❤️
keep up the good work guys!!!!!!!!!!Oh,I think you can also mention about the gross and microscopic features of the kidney in this condition. :)
0:12 NOOOOOO!!
Great video tho thx! I have a final exam in 6 days and this is helping out a lot!
You guys rock! ;)
Thanks for the feedback! Hoping that you ace your final exam! Feel free to checkout osmosis.org for more video content that can aid you in your medical journey!
Thank u sooo muchh guys for making such videos. Really helps me a lottt. M about to complete my final year nd this is my only favourite way to learn. 😘 can anyone plzz suggest some surgery and obs gynae video channels as well plzzzzz
We'll get there eventually! Thanks for watching! Did you know that if you like & review us on Facebook then you’ll get access to our videos a day before they’re published on UA-cam? Check it out here: bit.ly/2u35D6J
Thank you for making these videos about renal system. A great tool for my study.
I have Acute Pylenuphritis and i cannot get a Urologist to take this serious!! I've been hospitalized in 2004 for it, and been doing well up until now, had a bit of yeast infection that immediately went into my left kidney causing flare-up of Pyelonephritis and doc won't Rx antibiotics long enough to zap this stuff. Now it will get worse and eventually i bet i end up in hospital...(so many docs r clueless of this acute condition)
Research the herb Cat’s Claw. It’s been a God send for me.
How are u now? What are u taking?
Are you alive ?
Thank you - very good!!!
Great job guys ! Well done ! Thank you !
What about obstructive and non obstructive pyelonephritis? What's the difference and what treatment do we use?
Thanks so much, wish to get the one of AGN🎉
Thanks u very much. I would like to ask for something, please can you mention the name of antibiotics? i know there is specifics antibiotics for staphylococcus or E. Coli or for the others, but i think it would be more easy to remember (for me as well) if you mention some tactical antibiotherapy on the video. Again Thanks you very much !
TNF & TLC
Trimethoprim/sulfamethoxazole
Nitrofurintoin
Levoflox
Cipro
Is dis the antibiotics to treat acute pylenephetis
@@shittunimot666 Yes.
Is amoxiclav is one of medicine of this thank u@@sharkparty1027
Thank you so much for making life easier
Thanks for making me clear about this topic 💜💜💜💜
Any time!
It’s not a joke having it
Great video. I have seminar tomorow on mixed culture involving urine sample
thanks for uploading such informative video lecture
Thank you Osmosis this is so helpful
really very clear explanation
Thank you for the amazing vids...
Thanks for watching, Amna! Did you know that if you like & review us on Facebook then you’ll get access to our videos a day before they’re published on UA-cam? Check it out here: bit.ly/2u35D6J
Very informative! and easy to understand!
you are awesome thank you osmosis team
wish the subscription had a discount code.
Hi! We do have discounts that you may take advantage of! You may email our team at support@osmosis.org and inquire about a special discount ❤️
thanks
Thanks for tuning in Usman!
Blood in liver, protein in kidneyx
Really helpful for a quick review :)
I was diagnosed with Left acute pyelonephritis last week. I'm on antibiotics right now
What did u get prescribed and mg f?
Tulsi leaves and mint leaves ( pudina) 15 day as a tea 100%
Desi 😂
Great video! waiting on the other COPD video :)
Best description
Thank you, Arfa! 😊
What is the difference between Pyelonephritis and Acute Interstitial Nephritis?
helpful!! Thank you!!😊
Thanks so much! It would be awesome if you could review us on our Facebook page. facebook.com/OsmoseIt/
Osmosis ohh okk will give u review soon!!
I took my Mum to Doctors for 8 weeks she was diagnosed with UDI we got medication returned to Doctors for Blood Test blood pressure and urine test,he said she was clear of infection ,She dropped dead in my arms 6 weeks later l demanded autopsy and got one and Sepsis and pyclonephitis She is dead because he did noot fulfill his duty of care l want him gone so he can get a job he can do
Is there slides available with the above information?
There is not found a valve at the junction of ureter and bladder. It's physiologic valve, not a real one.
Yes I think what they meant was the reflux of urine due to the low/more horizontal implantation of the ureters so that the ureter can't be compressed by the bladder wall when the bladder is full
I've see your video more than k-pop lol thanks for the funny lecture!
Thank you !!
Thanks. It helps
You're welcome! 💖
Is there a treatment for an anatomical valve problem
What about Chronic pyelonephritis ? Is there a video of it 🥲🥲 pls
Hi Zainab! We do have a video on Chronic Pyelonephritis over at osmosis.org. please feel free to signup for a trial account to access our entire video library. 💖
With acute pyelonephritis. «pyelo» means pelvis and «neph» refers to the kidney. So in this case it’s the renal pelvis, which is the funnel-like structure of the kidney that drains urine into the ureter and «itis» means inflammation.
So acute pyelonephritis describes an inflamed kidney that develops relatively quickly, usually as result of a bacterial infection. Now a urinary tract infection ( or UTI) is any infection of the urinary tract, which includes the upper portion of the tract ( the kidneys and the ureters) and the lower portion of the tract ( the bladder and the urethra)
So acute pyelonephritis is a type of upper urinary tract infection. Acute pyelonephritis is most often caused by ascending infection: meaning bacteria start by colonizing the urethra and bladder which would be a lower urinary tract infection and make their way up the ureter to the kidney.
Therefore, upper UTI shares a lot of the same risk factors as lower UTI, things like female sex, sexual intercourse, indwelling catheters, diabetes mellitus, and urinary tract obstruction.
One major factor that increases the risk of an upper UTI from a lower UTI spreading upward is vesicoureteral reflux or VUR. Which is where urine is allowed to move backward up the urinary tract which can happen if the vasioureteral orifice fails.
The vasicoureteral orifice is the one way valve that allows urine to flow from each ureter into the bladder, but not in the reverse direction. VUR can be the result of a primary congenital defect or it can be caused by bladder outlet obstruction, which increases pressure in the bladder and distorts the valve
As kind of a double whammy, obstruction also leads to urinary stasis where urine stands still. Which makes it easier for bacteria to adhere and colonize the urinary tract.
So for ascending infections that cause acute pyelonephritis, the most common organisms are E. coli, Proteus species, and Enterobacter species, all of which are commonly found in the bowel flora. Now, it's also possible that the kidneys get infected via hematogenous infection, or spread through the bloodstream, although this is a lot less common. Usually, pyelonephritis from hematogenous spread is a consequence of septicemia or bacteremia --which is bacteria in the blood-- as well as infective endocarditis, an infection of the inner layer of the heart.
In these situations, the most common organisms are Staphylococcus species and, again, E.coli. Acute pyelonephritis is most often unilateral --meaning it affects just one kidney-and when bacteria mount an attack, they usually start by adhering to the renal epithelium of the tubules, which triggers an inflammatory response. Chemokines attract neutrophils to the renal interstitium, but typically the glomeruli and vessels of the kidney are spared.
As neutrophils infiltrate and die off, they make their way through the urinary tract, and are peed out; so people with acute pyelonephritis often have white blood cells in their urine. Sometimes the cells and the surrounding inflammatory protein debris is even "casted" [sic] into the shape of the tubule which is then also peed out and is called a white blood cell cast. Patients also can present with increased white blood cells in their blood --called leukocytosis- and as a result of the inflammatory immune response, patients can also develop fevers, chills, nausea and vomiting, as well as flank pain at the costovertebral angle.
These systemic symptoms are what often distinguish acute pyelonephritis from a lower urinary tract infection. Treatment is typically antibiotics and making sure that the individual stays well hydrated. Like most bacterial infections, there's also a possibility of a renal abscess that can form as a complication. Also, if there are recurrent infections --which can be the case in people with an anatomic problem that allows bacteria to easily cause infections- then it can lead to chronic pyelonephritis, as well as papillary necrosis --or death of the renal papillae tissue-which has a much worse prognosis because that can affect the kidney's overall ability to function.
All right, as a quick recap: Acute pyelonephritis is typically a bacterial infection of the upper urinary tract, which usually develops from a lower urinary tract infection, especially in individuals with vesicoureteral reflux. The infection causes systemic symptoms like fevers and flank pain at INFECTION the costvertebral angle and is treated with antibiotics. then it can lead to chronic pyelonephritis, as well as papillary necrosis --or death of the renal papillae tissue- which has a much worse prognosis because that can affect the kidney's overall ability to function. All right, as a quick recap: Acute pyelonephritis is typically a bacterial infection of the upper urinary tract, which usually develops from a lower urinary tract infection, especially in individuals with vesicoureteral reflux. The infection causes systemic symptoms like fevers and flank pain at INFECTION the costvertebral angle and is treated with antibiotics.
Please which to find out if this can cause the bladder to be washed when one can’t pass urine normally?
شكراً جزيلاً 😍🌷
Thank you so much this is so helpful! 16/11/2018 😃😃
does holding pee for long time cause Vesico urethral reflux?
and also waiting for video on Myasthenia Gravis.
I wanted to study that :)
me too bro
Fantastic thank you
Veiscouteral reflex
Thank you tooooooooo much
How can I site this video?
My Dad got this recurrently over the last 50 years. He always used to get hospitalized. The only drugs that worked were given by IV
What is his kidney function ?
@@rebbedoes he’s dead
@@kimsung2384 i'm sorry to hear that , my condolences . I had kidney infection and my gfr went from 90 to 50 . Quite shocking ..it happend 2 months ago . I'm 31 years old , male
@@rebbedoes Thank you for your kind words. Sadly death is an integral part of life. Really sorry to hear about your kidney issues. I take it you’ve seen your doctor? What did they say? Yes my dad had recurrent kidney infection from the 1970s
Thank u sir👍
Sir do heart related drugs effect on kidneys cuz my father had Stenting in 2019 and since then he is on jubira gold tablet ( Aspirin, Clopidogrel and Rosuvastatin ) and his having continues urinary track infections so his kidneys are getting damage plz answer sir 🙏he's also diabetic but had no kidney problem before heart operation and also his urine bladder is a bit enlarged
When you came to know his bladder was also bit enlarged & within in a year how many recurrent uti cases were known to him? + is he diabetic type 1 or 2
Great 👍🏻
Tq
You're welcome! 😊
It's gem🌈💐🌹
I hate that feeling
Is it vesico_ureteral reflux or vesico_urethral reflux?
Urteral bcz urine is going from bladder to ureter back
Is this possible to get as a man..?
Yes but less and need more investigation
loads flof love from Pakistan!
Diabetes for 1 1/2 year. Bad wheat breads,allergy's
Too much Coffee in the 1st mornings
Thanks for helping going over this disgusting not understandable lectures .
Perché il diabete è un fattore di rischio????
Let me wait here with you for that answer
I came her because of Ms Lara.😣
Same
🔥🔥🔥🔥
Sankeo
💜
Here it's f ree. In the app u should pay
Hi Zahra! Thanks for the feedback! The entire Osmosis video library has over 2200 medical and nursing videos on osmosis.org. Our UA-cam channel contains only ~10% of our video library, and access to a single title may change over time. We hope this was able to help. 🙏🏼
💓💓💓🙏
I got all if this- for a year - catheters from July. Escondido, .ca ( 81 years old) -- Too much Sugar !!.Constipation for 2 years
Thanks
thank you
Thanks
😊
thank you!!
With acute pyelonephritis. «pyelo» means pelvis and «neph» refers to the kidney. So in this case it’s the renal pelvis, which is the funnel-like structure of the kidney that drains urine into the ureter and «itis» means inflammation.
So acute pyelonephritis describes an inflamed kidney that develops relatively quickly, usually as result of a bacterial infection. Now a urinary tract infection ( or UTI) is any infection of the urinary tract, which includes the upper portion of the tract ( the kidneys and the ureters) and the lower portion of the tract ( the bladder and the urethra)
So acute pyelonephritis is a type of upper urinary tract infection. Acute pyelonephritis is most often caused by ascending infection: meaning bacteria start by colonizing the urethra and bladder which would be a lower urinary tract infection and make their way up the ureter to the kidney.
Therefore, upper UTI shares a lot of the same risk factors as lower UTI, things like female sex, sexual intercourse, indwelling catheters, diabetes mellitus, and urinary tract obstruction.
One major factor that increases the risk of an upper UTI from a lower UTI spreading upward is vesicoureteral reflux or VUR. Which is where urine is allowed to move backward up the urinary tract which can happen if the vasioureteral orifice fails.
The vasicoureteral orifice is the one way valve that allows urine to flow from each ureter into the bladder, but not in the reverse direction. VUR can be the result of a primary congenital defect or it can be caused by bladder outlet obstruction, which increases pressure in the bladder and distorts the valve
As kind of a double whammy, obstruction also leads to urinary stasis where urine stands still. Which makes it easier for bacteria to adhere and colonize the urinary tract.
So for ascending infections that cause acute pyelonephritis, the most common organisms are E. coli, Proteus species, and Enterobacter species, all of which are commonly found in the bowel flora. Now, it's also possible that the kidneys get infected via hematogenous infection, or spread through the bloodstream, although this is a lot less common. Usually, pyelonephritis from hematogenous spread is a consequence of septicemia or bacteremia --which is bacteria in the blood-- as well as infective endocarditis, an infection of the inner layer of the heart.
In these situations, the most common organisms are Staphylococcus species and, again, E.coli. Acute pyelonephritis is most often unilateral --meaning it affects just one kidney-and when bacteria mount an attack, they usually start by adhering to the renal epithelium of the tubules, which triggers an inflammatory response. Chemokines attract neutrophils to the renal interstitium, but typically the glomeruli and vessels of the kidney are spared.
As neutrophils infiltrate and die off, they make their way through the urinary tract, and are peed out; so people with acute pyelonephritis often have white blood cells in their urine. Sometimes the cells and the surrounding inflammatory protein debris is even "casted" [sic] into the shape of the tubule which is then also peed out and is called a white blood cell cast. Patients also can present with increased white blood cells in their blood --called leukocytosis- and as a result of the inflammatory immune response, patients can also develop fevers, chills, nausea and vomiting, as well as flank pain at the costovertebral angle.
These systemic symptoms are what often distinguish acute pyelonephritis from a lower urinary tract infection. Treatment is typically antibiotics and making sure that the individual stays well hydrated. Like most bacterial infections, there's also a possibility of a renal abscess that can form as a complication. Also, if there are recurrent infections --which can be the case in people with an anatomic problem that allows bacteria to easily cause infections- then it can lead to chronic pyelonephritis, as well as papillary necrosis --or death of the renal papillae tissue-which has a much worse prognosis because that can affect the kidney's overall ability to function.
All right, as a quick recap: Acute pyelonephritis is typically a bacterial infection of the upper urinary tract, which usually develops from a lower urinary tract infection, especially in individuals with vesicoureteral reflux. The infection causes systemic symptoms like fevers and flank pain at INFECTION the costvertebral angle and is treated with antibiotics. then it can lead to chronic pyelonephritis, as well as papillary necrosis --or death of the renal papillae tissue- which has a much worse prognosis because that can affect the kidney's overall ability to function. All right, as a quick recap: Acute pyelonephritis is typically a bacterial infection of the upper urinary tract, which usually develops from a lower urinary tract infection, especially in individuals with vesicoureteral reflux. The infection causes systemic symptoms like fevers and flank pain at INFECTION the costvertebral angle and is treated with antibiotics.
With acute pyelonephritis. «pyelo» means pelvis and «neph» refers to the kidney. So in this case it’s the renal pelvis, which is the funnel-like structure of the kidney that drains urine into the ureter and «itis» means inflammation.
So acute pyelonephritis describes an inflamed kidney that develops relatively quickly, usually as result of a bacterial infection. Now a urinary tract infection ( or UTI) is any infection of the urinary tract, which includes the upper portion of the tract ( the kidneys and the ureters) and the lower portion of the tract ( the bladder and the urethra)
So acute pyelonephritis is a type of upper urinary tract infection. Acute pyelonephritis is most often caused by ascending infection: meaning bacteria start by colonizing the urethra and bladder which would be a lower urinary tract infection and make their way up the ureter to the kidney.
Therefore, upper UTI shares a lot of the same risk factors as lower UTI, things like female sex, sexual intercourse, indwelling catheters, diabetes mellitus, and urinary tract obstruction.
One major factor that increases the risk of an upper UTI from a lower UTI spreading upward is vesicoureteral reflux or VUR. Which is where urine is allowed to move backward up the urinary tract which can happen if the vasioureteral orifice fails.
The vasicoureteral orifice is the one way valve that allows urine to flow from each ureter into the bladder, but not in the reverse direction. VUR can be the result of a primary congenital defect or it can be caused by bladder outlet obstruction, which increases pressure in the bladder and distorts the valve
As kind of a double whammy, obstruction also leads to urinary stasis where urine stands still. Which makes it easier for bacteria to adhere and colonize the urinary tract.
So for ascending infections that cause acute pyelonephritis, the most common organisms are E. coli, Proteus species, and Enterobacter species, all of which are commonly found in the bowel flora. Now, it's also possible that the kidneys get infected via hematogenous infection, or spread through the bloodstream, although this is a lot less common. Usually, pyelonephritis from hematogenous spread is a consequence of septicemia or bacteremia --which is bacteria in the blood-- as well as infective endocarditis, an infection of the inner layer of the heart.
In these situations, the most common organisms are Staphylococcus species and, again, E.coli. Acute pyelonephritis is most often unilateral --meaning it affects just one kidney-and when bacteria mount an attack, they usually start by adhering to the renal epithelium of the tubules, which triggers an inflammatory response. Chemokines attract neutrophils to the renal interstitium, but typically the glomeruli and vessels of the kidney are spared.
As neutrophils infiltrate and die off, they make their way through the urinary tract, and are peed out; so people with acute pyelonephritis often have white blood cells in their urine. Sometimes the cells and the surrounding inflammatory protein debris is even "casted" into the shape of the tubule which is then also peed out and is called a white blood cell cast. Patients also can present with increased white blood cells in their blood --called leukocytosis- and as a result of the inflammatory immune response, patients can also develop fevers, chills, nausea and vomiting, as well as flank pain at the costovertebral angle.
These systemic symptoms are what often distinguish acute pyelonephritis from a lower urinary tract infection. Treatment is typically antibiotics and making sure that the individual stays well hydrated. Like most bacterial infections, there's also a possibility of a renal abscess that can form as a complication. Also, if there are recurrent infections --which can be the case in people with an anatomic problem that allows bacteria to easily cause infections- then it can lead to chronic pyelonephritis, as well as papillary necrosis --or death of the renal papillae tissue-which has a much worse prognosis because that can affect the kidney's overall ability to function.
All right, as a quick recap: Acute pyelonephritis is typically a bacterial infection of the upper urinary tract, which usually develops from a lower urinary tract infection, especially in individuals with vesicoureteral reflux. The infection causes systemic symptoms like fevers and flank pain at the costvertebral angle and is treated with antibiotics.
Send me
Thanks
With acute pyelonephritis. «pyelo» means pelvis and «neph» refers to the kidney. So in this case it’s the renal pelvis, which is the funnel-like structure of the kidney that drains urine into the ureter and «itis» means inflammation.
So acute pyelonephritis describes an inflamed kidney that develops relatively quickly, usually as result of a bacterial infection. Now a urinary tract infection ( or UTI) is any infection of the urinary tract, which includes the upper portion of the tract ( the kidneys and the ureters) and the lower portion of the tract ( the bladder and the urethra)
So acute pyelonephritis is a type of upper urinary tract infection. Acute pyelonephritis is most often caused by ascending infection: meaning bacteria start by colonizing the urethra and bladder which would be a lower urinary tract infection and make their way up the ureter to the kidney.
Therefore, upper UTI shares a lot of the same risk factors as lower UTI, things like female sex, sexual intercourse, indwelling catheters, diabetes mellitus, and urinary tract obstruction.
One major factor that increases the risk of an upper UTI from a lower UTI spreading upward is vesicoureteral reflux or VUR. Which is where urine is allowed to move backward up the urinary tract which can happen if the vasioureteral orifice fails.
The vasicoureteral orifice is the one way valve that allows urine to flow from each ureter into the bladder, but not in the reverse direction. VUR can be the result of a primary congenital defect or it can be caused by bladder outlet obstruction, which increases pressure in the bladder and distorts the valve
As kind of a double whammy, obstruction also leads to urinary stasis where urine stands still. Which makes it easier for bacteria to adhere and colonize the urinary tract.
So for ascending infections that cause acute pyelonephritis, the most common organisms are E. coli, Proteus species, and Enterobacter species, all of which are commonly found in the bowel flora. Now, it's also possible that the kidneys get infected via hematogenous infection, or spread through the bloodstream, although this is a lot less common. Usually, pyelonephritis from hematogenous spread is a consequence of septicemia or bacteremia --which is bacteria in the blood-- as well as infective endocarditis, an infection of the inner layer of the heart.
In these situations, the most common organisms are Staphylococcus species and, again, E.coli. Acute pyelonephritis is most often unilateral --meaning it affects just one kidney-and when bacteria mount an attack, they usually start by adhering to the renal epithelium of the tubules, which triggers an inflammatory response. Chemokines attract neutrophils to the renal interstitium, but typically the glomeruli and vessels of the kidney are spared.
As neutrophils infiltrate and die off, they make their way through the urinary tract, and are peed out; so people with acute pyelonephritis often have white blood cells in their urine. Sometimes the cells and the surrounding inflammatory protein debris is even "casted" into the shape of the tubule which is then also peed out and is called a white blood cell cast. Patients also can present with increased white blood cells in their blood --called leukocytosis- and as a result of the inflammatory immune response, patients can also develop fevers, chills, nausea and vomiting, as well as flank pain at the costovertebral angle.
These systemic symptoms are what often distinguish acute pyelonephritis from a lower urinary tract infection. Treatment is typically antibiotics and making sure that the individual stays well hydrated. Like most bacterial infections, there's also a possibility of a renal abscess that can form as a complication. Also, if there are recurrent infections --which can be the case in people with an anatomic problem that allows bacteria to easily cause infections- then it can lead to chronic pyelonephritis, as well as papillary necrosis --or death of the renal papillae tissue-which has a much worse prognosis because that can affect the kidney's overall ability to function.
All right, as a quick recap: Acute pyelonephritis is typically a bacterial infection of the upper urinary tract, which usually develops from a lower urinary tract infection, especially in individuals with vesicoureteral reflux. The infection causes systemic symptoms like fevers and flank pain at the costvertebral angle and is treated with antibiotics.
Thanks
You're welcome, Qawasa! 🙏🏼
With acute pyelonephritis. «pyelo» means pelvis and «neph» refers to the kidney. So in this case it’s the renal pelvis, which is the funnel-like structure of the kidney that drains urine into the ureter and «itis» means inflammation.
So acute pyelonephritis describes an inflamed kidney that develops relatively quickly, usually as result of a bacterial infection. Now a urinary tract infection ( or UTI) is any infection of the urinary tract, which includes the upper portion of the tract ( the kidneys and the ureters) and the lower portion of the tract ( the bladder and the urethra)
So acute pyelonephritis is a type of upper urinary tract infection. Acute pyelonephritis is most often caused by ascending infection: meaning bacteria start by colonizing the urethra and bladder which would be a lower urinary tract infection and make their way up the ureter to the kidney.
Therefore, upper UTI shares a lot of the same risk factors as lower UTI, things like female sex, sexual intercourse, indwelling catheters, diabetes mellitus, and urinary tract obstruction.
One major factor that increases the risk of an upper UTI from a lower UTI spreading upward is vesicoureteral reflux or VUR. Which is where urine is allowed to move backward up the urinary tract which can happen if the vasioureteral orifice fails.
The vasicoureteral orifice is the one way valve that allows urine to flow from each ureter into the bladder, but not in the reverse direction. VUR can be the result of a primary congenital defect or it can be caused by bladder outlet obstruction, which increases pressure in the bladder and distorts the valve
As kind of a double whammy, obstruction also leads to urinary stasis where urine stands still. Which makes it easier for bacteria to adhere and colonize the urinary tract.
So for ascending infections that cause acute pyelonephritis, the most common organisms are E. coli, Proteus species, and Enterobacter species, all of which are commonly found in the bowel flora. Now, it's also possible that the kidneys get infected via hematogenous infection, or spread through the bloodstream, although this is a lot less common. Usually, pyelonephritis from hematogenous spread is a consequence of septicemia or bacteremia --which is bacteria in the blood-- as well as infective endocarditis, an infection of the inner layer of the heart.
In these situations, the most common organisms are Staphylococcus species and, again, E.coli. Acute pyelonephritis is most often unilateral --meaning it affects just one kidney-and when bacteria mount an attack, they usually start by adhering to the renal epithelium of the tubules, which triggers an inflammatory response. Chemokines attract neutrophils to the renal interstitium, but typically the glomeruli and vessels of the kidney are spared.
As neutrophils infiltrate and die off, they make their way through the urinary tract, and are peed out; so people with acute pyelonephritis often have white blood cells in their urine. Sometimes the cells and the surrounding inflammatory protein debris is even "casted" into the shape of the tubule which is then also peed out and is called a white blood cell cast. Patients also can present with increased white blood cells in their blood --called leukocytosis- and as a result of the inflammatory immune response, patients can also develop fevers, chills, nausea and vomiting, as well as flank pain at the costovertebral angle.
These systemic symptoms are what often distinguish acute pyelonephritis from a lower urinary tract infection. Treatment is typically antibiotics and making sure that the individual stays well hydrated. Like most bacterial infections, there's also a possibility of a renal abscess that can form as a complication. Also, if there are recurrent infections -which can be the case in people with an anatomic problem that allows bacteria to easily cause infections- then it can lead to chronic pyelonephritis, as well as papillary necrosis -or death of the renal papillae tissue-which has a much worse prognosis because that can affect the kidney's overall ability to function.
All right, as a quick recap: Acute pyelonephritis is typically a bacterial infection of the upper urinary tract, which usually develops from a lower urinary tract infection, especially in individuals with vesicoureteral reflux. The infection causes systemic symptoms like fevers and flank pain at the costvertebral angle and is treated with antibiotics.