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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Spanish version
Illustration
Illustration
Pyelonephritis
What is pyelonephritis?
Pyelonephritis is a bacterial infection of the kidney. It
can be serious because of the important function of the
kidneys and because the infection may enter the bloodstream.
It can also cause pregnant women to go into labor too early
(premature labor).
Kidney infections are much more common in women than men.
How does it occur?
Most kidney infections result from lower urinary tract
infections, usually bladder infections.
Bacteria can travel from the vagina or rectal area (anus)
into the urethra and bladder. The urethra is the tube that
empties urine from the bladder. A woman's urethra is short,
about 2 inches long, and is just above the vagina. Because
of the location and short length of the female urethra,
women are more likely to have bladder infections than men.
Lower urinary system infections may spread to the kidneys,
causing pyelonephritis. When you have a bladder infection,
the usual mechanism that prevents urine from flowing back to
the kidneys does not work properly. This problem can allow
infected urine to move into the kidneys.
The urinary system is a common site of birth defects. If
your urinary system is abnormal, you have a greater risk
that a bladder infection will spread to the kidneys.
If you have blockage from a kidney stone, you are at risk
of developing pyelonephritis.
What are the symptoms?
The symptoms range from mild to severe. They may include:
- fever
- chills
- sweats
- abdominal pain
- back pain
- loss of appetite
- nausea
- vomiting
- problems with urination, such as pain when you urinate or
having a frequent urge to urinate.
Sometimes it is difficult to know whether urinary symptoms
are caused by an infection of the lower urinary tract (for
example, the bladder) or by a kidney infection. In either
case, these symptoms should not be ignored. If you have
these symptoms, see your health care provider immediately.
Even a simple bladder infection can rapidly progress to
pyelonephritis and infection in the bloodstream. Do not
allow the symptoms to continue for several days before you
seek treatment.
How is it diagnosed?
Your health care provider reviews your medical history,
looking especially for current or recent lower urinary tract
infection. You will also have a physical exam, especially
to check for pain in the kidney area. A sample of your
urine is tested in the lab.
How is it treated?
Antibiotics are the main treatment for a kidney infection.
Your health care provider may treat you first as an
outpatient. You may continue to be treated at home if you
show a good response to the antibiotic after 24 hours. If
you are more seriously ill or dehydrated or not responding
to the antibiotic, you may need to stay in the hospital.
You can be given IV medication and fluids in the hospital.
You will need to take antibiotics for at least 10 days. All
bacteria must be killed to prevent kidney damage and to keep
the infection from returning.
Your antibiotic may need to be changed after the first day
or two of treatment if lab tests of the bacteria in your
urine show a different antibiotic will work better. Your
health care provider will call you if this is the case.
How long do the symptoms last?
How long it takes you to recover depends on how severe your
symptoms are when you start treatment. In mild cases,
symptoms lessen in the first 1 to 2 days. More severe cases
require several days before you begin to feel better.
With proper treatment there are few complications of
pyelonephritis. If your symptoms return soon after you
finish your treatment, further tests may be necessary. Your
health care provider will determine whether an underlying
cause is present, such as a kidney stone.
How can I take care of myself?
- Notice whether your symptoms lessen once you start
taking the antibiotic.
- Drink a lot of fluids.
- Take all your medicine according to your health care
provider's instructions, even when you begin to feel
better.
- Promptly report worsening or recurrent symptoms to your
health care provider .
What can be done to help prevent pyelonephritis?
Most cases of pyelonephritis in women result from bladder
infections. The best way to prevent kidney infections is to
try to prevent bladder infections. Ways women can try to
prevent these infections are:
- Drink plenty of water and other noncaffeinated drinks.
(Caffeine can cause the body to lose fluids.)
- Avoid contaminating the urethra with bacteria from the
anal area by practicing good hygiene when you use the
toilet (for example, you should wipe from front to back).
- Avoid using irritating cosmetics or chemicals in the area
of the vagina and urethra (such as scented napkins or
panty liners).
- Urinate after you have sexual intercourse.
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