Pyelonephritis

Clinical Description

Acute pyelonephritis is a bacterial infection causing inflammation of the kidneys and is one of the most common diseases of the kidney. Pyelonephritis occurs as a complication of an ascending urinary tract infection (UTI) which spreads from the bladder to the kidneys and their collecting systems

Signs and Symptoms

• Fevers, costovertebral angle pain, nausea, vomiting

Investigations

• Full blood count
• Urine dipstick, microscopy, culture and sensitivity
• Urea, electrolytes and creatinine
• KUB Ultrasound

Pharmacological

• Give Ciprofloxacin 500mg orally 12 hourly for 10-14 days or
• Give Co-amoxiclav 375 mg 8 hourly for 10-14 days
• IV fluids if clinically indicated

Complications and referral criteria: Ongoing pain and fevers despite antibiotic use. Worsening of kidney function.

Alternatively

• Give Gentamycin 240mg IM or IV STAT
• Followed by any of the above oral antibiotics for 10-14 days
• Refer patients with recurrent UTI for further investigations