This document discusses pyelonephritis, which is a bacterial infection of the kidney. It notes that pyelonephritis differs from UTIs, which involve the urethra, and cystitis, which involves the bladder. The document outlines predisposing factors for pyelonephritis using the mnemonic "SCARRIN' UP" and lists common signs and symptoms such as fever, flank pain, and costovertebral angle tenderness. It also describes the types of pyelonephritis, including acute and chronic, and the diagnosis and treatment, which typically involves intravenous or oral antibiotics.

1. GROUP MEMBERS
POKHREL,BHARAT

3. PYELONEPHRITIS
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Bacterial infection of the kidney (RENAL
PELVIS)
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Difference from:
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UTI→ Involves Urethra
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Cystitis →Involves Bladder
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Female>Male
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Attributed to ascending bacteria along the path
of the URETER, E.coli (80%)

4. Predisposing Factors
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Mnemonics: SCARRIN' UP
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S- SEX (Female <40, Male >40)
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C- CATHETHERIZATION
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A- AGE (Infant and Elderly)
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R- RENAL LESIONS
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R- REFILUX (VESICOUTERAL)
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I- IMMUNODEFICIENT
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N- NIDDM, IDDM
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U- URINARY OBSTRUCTION
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P- PREGNANCY

5. Signs and Symptoms
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Fever and flank pain
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In very young and elderly patients
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Irritability, poor appetite, or altered mental status.
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Dysuria
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Nausea and vomiting (Non-specific)
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CVA(Costovertebral angle) Tenderness

6. CVA TENDERNESS

7. PATHOPHYSIOLOGY

8. TYPES
ACUTE PYELONEPHRITIS CHRONIC
PYELONEPHRITIS
l Characterized by fever,
flank pain,dysuria.
l Potential organ and life
threatening infection that
often leads to RENAL
SCARRING.
l DIAGNOSIS:
l Outpatient setting→ History
and PE with urinalysis.
l Characterized by Renal
Inflammation and fibrosis or
persistent renal infection,
vesicoureteral reflux or
other causes of urinary tract
obstruction.
l Associated with renal
scarring that may lead to
ESRD
l DIAGNOSIS
l Imaging studies like
ultrasound and CT scans

9. Can results to
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Renal scarring that is accelerated in the setting
of urinary obstruction
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Abscess that can be located within renal
parenchyma (RENAL ABSCESS) or between the
capsule and Gerota's fascia (PERINEPHRITIC
ABSCESS)
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Emphysematous pyelonephritis which can be a
life threatening condition.

10. DIAGNOSIS
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Urinalysis → Examines the appearance,
concentration and content of urine.
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Urine culture → To isolate the bacteria in the
urine
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Any patient not responding to Antibiotic therapy
after 72 hours should
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Undergo CT imaging to rule out an ABSCESS
OR OBSTRUCTION

11. TREATMENT
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INPATIENT with fever, sepsis, high WBC count
on urine → Give IV Antibiotics
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OUTPATIENT → Without too many risk factors
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Oral Antibiotics
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Most commonly Fluroquiniolones eg.
Ciprofloxacin, Levufloxacin
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Aminoglycosides (Gentamycin)
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Bactrim (Trimethoprim-sulfamethaxazole)