Overview, Causes, & Risk Factors
Pyelonephritis is an infection of the kidneys or the ureters. The ureters are small tubes that carry urine from the kidneys to the bladder. Pyelonephritis may come on suddenly or it may be a long-term problem.
What is going on in the body?
Escherichia coli is a bacteria that is normally found in the large intestine. It causes about 90 percent of kidney infections. These infections usually spread from the genital area through the ureters to the bladder. In a healthy urinary tract, the infection is prevented from going to the kidneys by the flow of urine, which washes organisms out. When bacteria enter the usually "germ-free" urinary tract, they can cause pyelonephritis.
What are the causes and risks of the infection?
Pyelonephritis is usually caused by bacteria entering the kidneys from the bladder. The most common causes of this bacteria reaching the bladder include:
use of a urinary catheter for draining urine from the bladder
surgery on the urinary tract
diagnostic testing that uses a scope to enter the urinary tract, such as cystoscopy
conditions that block the way the urine flows through the urinary tract, including uterine fibroids, benign prostatic hyperplasia, kidney stones, and pregnancy
conditions that make a person more prone to infection, such as diabetes
a problem with the urinary tract that is present at birth
Symptoms & Signs
What are the signs and symptoms of the infection?
Symptoms of pyelonephritis may include:
sudden fever, often over 102 to 103 degrees F
chills
severe pain and tenderness in the sides, abdomen, or back
tenderness when the kidneys are pressed
warm, moist, flushed skin
frequent urination
difficulty starting a stream of urine
pain or burning sensation when urinating
cloudy or abnormally colored urine
nausea
vomiting
diarrhea
fatigue
mental changes or confusion, as the infection progresses
Diagnosis & Tests
How is the infection diagnosed?
Diagnosis requires a urinalysis, or urine test. A urine culture is also done on a urine sample to see if there are bacteria in the urine. Typical findings include pus, white blood cells, and blood in the urine. X-rays are also helpful in the diagnosis.
Prevention & Expectations
What can be done to prevent the infection?
There are many ways to prevent the spread of bacteria in the urinary tract. These include:
wiping from the front to the back of the genital area, especially after a bowel movement
drinking plenty of fluids
emptying the bladder at least every 3 to 4 hours and after sexual intercourse
avoiding bubble baths
avoiding tight fitting clothes
wearing cotton underwear
What are the long-term effects of the infection?
Untreated pyelonephritis can lead to:
chronic kidney infections
permanent kidney damage
scarring of the kidneys
sepsis, or blood poisoning
What are the risks to others?
Pyelonephritis is not contagious. Certain conditions that increase a person's risk of kidney infection, such as sexually transmitted disease, may be very contagious.
Treatment & Monitoring
What are the treatments for the infection?
A person is usually given antibiotics as soon as the diagnosis of a kidney infection seems likely. The most common antibiotics prescribed include:
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