Pyelonephritis
- Most commonly caused by aerobic gram negative organisms including E. coli,
Proteus, and Pseudomonas.
- Gram positive organisms like Staphylococcus saprophyticus and enterococci
are less common.
Patients usually presents with an acute onset of fever, chills, flank pain and irritative voiding systoms. They often look quite ill. Percussion of the ipsilateral costovertebral angle elicits significant pain. Urinalysis shows heavy pyuria, bacteriuria, mild proteinuria and often microscopic haematuria.
Mild to moderate pyelonephritis can be treated on an outpatient basis with fluoroquinolones such as ciprofloxacin. More severe or complicated cases require admission to hospital with early upper tract imaging and wide pectrum antibiotics such as ampicillin and gentamycin.
Content by Dr Íomhar O' Sullivan 11/05/2005. Reviewed by Dr ÍOS 26/05/2006. Next reeview 26/05/2007.
