Pyelonephritis history and symptoms: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Pyelonephritis}} | {{Pyelonephritis}} | ||
{{CMG}}; {{AE}} {{USAMA}} | |||
{{CMG}}{{AE}}{{USAMA}} | |||
==Overview== | ==Overview== | ||
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==History== | ==History== | ||
Patients with pyelonephritis can present with the history of following important findings<ref name="pmid12020306">{{cite journal| author=Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S| title=Does this woman have an acute uncomplicated urinary tract infection? | journal=JAMA | year= 2002 | volume= 287 | issue= 20 | pages= 2701-10 | pmid=12020306 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12020306 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12402822 Review in: Evid Based Nurs. 2002 Oct;5(4):119] </ref> | Patients with pyelonephritis can present with the history of following important findings:<ref name="pmid12020306">{{cite journal| author=Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S| title=Does this woman have an acute uncomplicated urinary tract infection? | journal=JAMA | year= 2002 | volume= 287 | issue= 20 | pages= 2701-10 | pmid=12020306 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12020306 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12402822 Review in: Evid Based Nurs. 2002 Oct;5(4):119] </ref> | ||
*Sudden symptom onset | *Sudden symptom onset | ||
*[[Fever]] | *[[Fever]] | ||
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*[[Renal stones]] | *[[Renal stones]] | ||
*Previous pyelonephritis | *Previous pyelonephritis | ||
*[[ | *[[Tumor]] | ||
*Cyst or [[abscess]] in the urinary tract | *[[Cyst]] or [[abscess]] in the urinary tract | ||
==Symptoms== | ==Symptoms== | ||
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===Symptoms in Elderly=== | ===Symptoms in Elderly=== | ||
In elderly, | In elderly, pyelonephritis can present as | ||
*[[Confusion]] | *[[Confusion]] | ||
*Disoriented speech | *Disoriented speech | ||
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===Urinary symptoms=== | ===Urinary symptoms=== | ||
Urinary symptoms of pyelonephritis can include: | |||
*[[Frequency]]-[[Frequent urination]] | *[[Frequency]]-[[Frequent urination]] | ||
*[[Urgency]]-[[urgent need to urinate]] | *[[Urgency]]-[[urgent need to urinate]] | ||
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*[[Dysuria]]-Painful urination | *[[Dysuria]]-Painful urination | ||
*Low volume voids | *Low volume voids | ||
*[[ | *[[Hematuria]]-blood in the urine | ||
*Foul or strong urine odour | *Foul or strong urine odour | ||
*Abnormal urine color (cloudy) | *Abnormal urine color (cloudy) | ||
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*Pressure in the lower pelvis or back | *Pressure in the lower pelvis or back | ||
*[[Flank pain]] or [[back pain]] | *[[Flank pain]] or [[back pain]] | ||
===Neurological=== | ===Neurological=== | ||
In elderly, pyelonephritis may present as | In elderly, pyelonephritis may present as | ||
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===Cardiovascular System=== | ===Cardiovascular System=== | ||
*[[Tachycardia]] | *[[Tachycardia]] | ||
===General Symptoms=== | ===General Symptoms=== | ||
*[[Chills]] | *[[Chills]] | ||
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{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Nephrology]] | [[Category:Nephrology]] | ||
[[Category:Primary care]] | [[Category:Primary care]] | ||
Revision as of 15:22, 4 April 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
Pyelonephritis patients usually present in the emergency department with sudden development of pain radiating to the flank in the presence of dysuria and fever. The differentiation of Pyelonephritis from other causes of dysuria is based on severity of symptoms and the typical radiation of pain. A thorough history and examination is required to differentiate pyelonephritis from other causes of dysuria and flank pain.[1]
History
Patients with pyelonephritis can present with the history of following important findings:[2]
- Sudden symptom onset
- Fever
- Recent urinary tract infection
- Diabetes
- Immunosuppression
- Known structural defect of the urinary tract
- Renal stones
- Previous pyelonephritis
- Tumor
- Cyst or abscess in the urinary tract
Symptoms
Patients with pyelonephritis can report the following symptoms:[2][3][4][5]
Symptoms requiring urgent management
- Fever- usually high grade
- Dysuria (painful voiding of urine)
- Abdominal pain (radiating to the back on the affected side)
- Rib or back pain
- Rigors (violent shivering while the temperature rises)
Other Common Symptoms
- Frequency
- Urgency
- Hematuria
- Constitutional symptoms (weakness, decreased appetite etc)
- Vomiting or Nausea
- Delirium
- Headache
Symptoms in infants
Pyelonephritis in infants and children less than 2 years may present as
- Fever
- Fussiness
- Decreased appetite
- Signs of urinary tract infection may be missing
Symptoms in Elderly
In elderly, pyelonephritis can present as
- Confusion
- Disoriented speech
- Hallucinations
Urinary symptoms
Urinary symptoms of pyelonephritis can include:
- Frequency-Frequent urination
- Urgency-urgent need to urinate
- Nocturia-Need to urinate at night
- Dysuria-Painful urination
- Low volume voids
- Hematuria-blood in the urine
- Foul or strong urine odour
- Abnormal urine color (cloudy)
Gastrointestinal
- Abdominal pain or pain radiating to the flank
- Nausea and vomiting
Musculoskeletal
- Pressure in the lower pelvis or back
- Flank pain or back pain
Neurological
In elderly, pyelonephritis may present as
Cardiovascular System
General Symptoms
References
- ↑ Schaeffer AJ (2000). "Urinary tract infections: antimicrobial resistance". Curr Opin Urol. 10 (1): 23–4. PMID 10650510.
- ↑ 2.0 2.1 Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S (2002). "Does this woman have an acute uncomplicated urinary tract infection?". JAMA. 287 (20): 2701–10. PMID 12020306. Review in: Evid Based Nurs. 2002 Oct;5(4):119
- ↑ Korkes F, Favoretto RL, Bróglio M, Silva CA, Castro MG, Perez MD (2008). "Xanthogranulomatous pyelonephritis: clinical experience with 41 cases". Urology. 71 (2): 178–80. doi:10.1016/j.urology.2007.09.026. PMID 18308077.
- ↑ Leonie G. M. Giesen, Grainne Cousins, Borislav D. Dimitrov, Floris A. van de Laar & Tom Fahey (2010). "Predicting acute uncomplicated urinary tract infection in women: a systematic review of the diagnostic accuracy of symptoms and signs". BMC family practice. 11: 78. doi:10.1186/1471-2296-11-78. PMID 20969801.
- ↑ Shaikh N, Morone NE, Lopez J, Chianese J, Sangvai S, D'Amico F; et al. (2007). "Does this child have a urinary tract infection?". JAMA. 298 (24): 2895–904. doi:10.1001/jama.298.24.2895. PMID 18159059.