KIDNEY URETER Infections 2 acute pylonephritis

ACUTE PYELONEPHRITIS

The  symptoms usually develop rapidly in a few hours and  include

high  fever,  chills,  nausea and vomiting.  There  is  pain  and

tenderness in the renal angle.

On  investigation, there is marked leucocytosis and pus cells  in

the urine with leucocyte casts. Organisms can be cultured in  the

urine and their sensitivity to antibiotics, identified.

8.2.1 Treatment

1.  A  10-14  day  treatment  with   Trimethoprim-Sulfamethazole,

Cephalosporin  or  Ampicillin  usually  controls  the  infection,

unless it is associated with the presence of stones, obstruction,

diabetes or tumour. In such cases, treatment is required for upto

6  weeks,  in  addition  to this,  treatment  of  the  underlying

condition to prevent repeated attacks.

Genitourinary  tuberculosis is secondary to tuberculosis  in  the

lungs of bones. The bacilli reach the kidney by the blood  stream

and  an  ulcero-cavernous lesion forms in the  carlico  medullary

region in 90% of cases. Living bacilli flow down in the urine and

cause   lesions  at  PUJ  ureter,  bladder,   seninal   vesicles,

epidiolymes   and  testis.  Lesions  in  the  ureter  can   cause

obstruction. Treatment is with antitubercular therapy

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