Pyelonephritis can be fatal in people with compromised health.
Bacterial infections are not all the same. Its effects depend both on the bacteria that are carrying out the infection, as well as on the part of our body affected and our state of health prior to infection.
Currently, the scientific-medical community fears a future global crisis caused by infectious diseases , since the abuse of antibiotics has caused bacteria resistant to them to become more and more frequent.
In today’s article we will talk about a common and potentially lethal type of kidney infection in some cases, pyelonephritis.
What is pyelonephritis?
Pyelonephritis is an infection of the urinary tract , such as a typical cystitis, which ends up affecting one or both kidneys . This happens for various reasons, but basically the infection manages to ascend through the urinary tract, from where it can reach the kidneys. Once the infection reaches the kidney area we are talking about pyelonephritis.
Pyelonephritis is a disease with quite variable symptoms and clinical presentation, depending on the health status of the patient and other clinical characteristics of the disease that we will discuss below.
It mainly affects women, due to the morphology of their urinary tract . His urethra is very close to the anus and is short, which makes it easy for bacteria to “climb” through the excretory system to reach the kidneys. It affects 0.5% of women per year, four times more than men.
In patients older than 65 years of age, mortality from pyelonephritis is approximately 40%.
- It might interest you: “Cystitis (urinary infection): causes, symptoms and treatment”
Symptoms
As we have previously mentioned, pyelonephritis has a wide range of clinical and symptomatic presentations, depending on patient factors such as age, sexual activity, or the patient’s gender, among others.
In addition, there are two types of pyelonephritis clinically differentiated according to whether there are factors that can complicate treatment:
1. Complicated pyelonephritis
Complicated pyelonephritis cases are those in which the patient affected by pyelonephritis has previous malformations of the urinary structure or other problems that can aggravate the disease or make treatment difficult, such as kidney or bladder stones (kidney or bladder stones), cysts renal or obstructions of the urinary excretory apparatus.
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2. Uncomplicated pyelonephritis
Uncomplicated pyelonephritis cases have a simpler treatment and tend to improve more easily , in addition to having little recurrence. In these cases, the patient would not present structures or malformations that aggravate the disease or hinder treatment.
In general, the symptoms of pyelonephritis are:
- Fever
- Shaking chills
- Headache
- dizziness
- Low back pain that may radiate to the rest of the abdomen or groin
- Problems urinating (pain, feeling of incontinence…)
Although not all patients present them in the same way or with the same severity , which makes their diagnosis somewhat difficult. The initial symptoms may be different, similar to those of a typical urinary tract infection, but worsen over the next 72 hours if this infection is not treated, leading to pyelonephritis.
In cases where the pyelonephritis is more advanced, the kidney infection can lead to sepsis , with potentially lethal effects, especially among the elderly.
Risk factor’s
Pyelonephritis mainly affects women. The infections that cause this disease are usually caused by fecal bacteria such as Escherichia coli , which come into contact with the urinary system due to contamination by feces. E.coli is the cause of 85% of uncomplicated infections in sexually active women.
Sexual activity increases the risk of pyelonephritis and other urinary tract infections in women . Other risk factors such as malformations of the urinary tract, the presence of stones or diabetes increase our chances of suffering from pyelonephritis.
Age is a risk factor as well . Not only does our risk of pyelonephritis and other urinary tract infections increase with age, but the severity of these also increases after age 65.
Treatment
The treatment of pyelonephritis varies depending on the type, complex or non-complex. Pyelonephritis without added anatomical complexities can be successfully treated with the use of antibiotics (always with a medical prescription), after which they usually improve in a period close to 48 or 72 hours.
In those cases in which the antibiotic treatment does not work, it is necessary to adapt the treatment to the bacteria that have been found in the patient’s urine tests, taking into account the types of bacterial resistance in the area from which it comes.
The existence of anatomical complexities such as obstructions or kidney stones often require surgical intervention to remedy the anatomical complexity before antibiotic treatment can be truly effective. Antibiotic treatment by itself will often not be enough for the total improvement of the patient, and may end up with chronic pyelonephritis.
In some rare cases, removal of the kidney is the best option to prevent the patient from long-term chronic infections.
Prevention
Urinary tract infections are extremely common. To avoid pyelonephritis we can practice certain habits that will protect us from urinary tract infections in general . These habits are healthy and worth practicing, especially if we know that we are prone to urinary tract infections.
Especially adult women with sexual activity, hydration throughout the day as well as correct hygienic practices when evacuating will reduce our risk of suffering from urinary tract infections . It is also recommended to urinate after sexual contact, since this decreases the associated risk of urinary tract infection in both sexes.
The use of condoms or other barrier – type methods of contraception also greatly increases the risk of urinary tract infections in women . It is recommended that if we have sexual intercourse with contraceptives of this type on a regular basis, we follow excellent hygienic practices and pay attention to symptoms of urinary tract infections, such as pain or burning when urinating.
Bibliographic references
- Johnson, James R., and Thomas A. Russo.(2018) “Acute Pyelonephritis in Adults.” New England Journal of Medicine 378, no. 1:48–59.
- Zhang, Y., Zang, GQ, Tang, ZH, & Yu, YS (2015). EMPHYSEMATOUS PYELONEPHRITIS. Journal of the Institute of Tropical Medicine of São Paulo, 57(4), 368.
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