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Pyelonephritis is an acute inflammatory infection of the renal parenchyma. Over time, it may lead to chronic Pyelonephritis, which gives its way to kidney failure.
The notable cause of Pyelonephritis is a gram-negative bacillus, the most common being E. Coli. The bacillus enters through the external urethra and proceeds upwards and settles in the urinary bladder. From the bladder, the bacillus further moves upwards through the ureter and reaches the kidneys. E. Coli, other gram-negative bacteria like Proteus, but Klebsiella and Enterobacter are also sometimes associated with the disease.
Although less in incidence, gram-positive bacillus like Staphylococcus Aureus has also been found to be the reason for Pyelonephritis.
Despite the defense mechanisms found in the urinary tract, there are several risk factors.
● The small length of the female urethra and the position of the urethral opening favors the entry of microorganisms during catheterization and sexual act.
● Urinary tract obstruction
● Low immune system
● Type 2 Diabetes Mellitus, polycystic kidneys, and other underlying disease conditions.
Sign and symptoms:
The early signs and symptoms include:
● Fever accompanied by chills
● Pain in the flank or lower back pain.
As the disease condition progresses, the signs and symptoms are-
● Blood in the urine (Hematuria)
● Painful urination (Dysuria)
● Pus in urine (Pyuria), the urine is cloudy in appearance.
● A detailed history collection about the type of pain and history of catheterization should be collected.
● Head to toe as well as Physical, systemic examination.
● Laboratory diagnostic tests such as complete blood count and urine culture are needed for determining the nature of bacillus.
● Computed tomography imaging
● Magnetic Resonance Imaging
● A broad-spectrum antibiotic course is needed even before the results of urine culture arrive. Waiting for urine culture reports may cause unnecessary delay, affecting the kidneys in the long run.
● NSAIDs can be used as pain killers if the patient is having Dysuria.
● Generally, anti-inflammatory medications are prescribed to curb the symptoms.
● The current treatment regimen suggests oral antibiotic for the first seven days followed by intravenous antibiotic therapy for the next 21 days.
● Drink plenty of water throughout the day. When excreted in the form of urine, water washes away any bacteria that may have settled in the urinary tract.
● Void the bladder as soon as you feel the need to urinate. Urine accumulation in the kidneys serves as a hotspot for bacterial growth.
● Maintain perineal hygiene. For females, you have to clean the perineum from front to back using a single stroke. For males, the penis is to be cleaned in a circular motion.
● Try to maintain a habit of urination after sexual intercourse.
● After using the washroom, try to use water instead of toilet paper. It reduces the chance of bacterial colonization.
● People who are pregnant or have any underlying disease have to be more careful in maintaining perineal hygiene.
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