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Running head: PYELONEPHRITIS

Pyelonephritis

Elisabeth Fandrich

Montana Tech Nursing Department

NURS 1566 Core Concepts of Adult Nursing

April 7, 2008

Noel Mathis RN, BSN, MSN

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Pyelonephritis

Also known as a kidney infection, pyelonephritis is an infection of the kidneys. It is usually an

ascending infection, meaning that an infection of the lower urinary tract has reached the pelvis

of the kidney. It occurs most often when there is a backflow of urine from the bladder into the

ureters or the pelvis of the kidney. Although cystitis (bladder infection) is common, the

occurrence of pyelonephritis is seen less.

The common signs and symptoms of pyelonephritis are flank pain, dysuria, abdominal pain that

radiates around to the back on the affected side, fatigue, fever, nausea and vomiting, diaphoresis,

urinary frequency, urinary urgency, nocturia, blood in the urine, cloudy or discolored urine,

mental status changes, and foul smelling urine.

3511,L,B presented to the emergency department complaining of severe abdominal pain and

mental status changes. A CT scan was done and it was determined that there was abnormal

dilation of the left urinary collecting system with urine and air. It was also noted that there was

extensive abnormal perinephretic fat stranding, and fluid along the spleen. These observations

are indicative of pyelonephritis and also the possibility of a recently passed kidney stone.

A urinalysis and labs were done upon admission. The urinalysis showed cloudy urine, with high

glucose, ketones and protein as well as a positive clinitest. As the patient is diabetic, this

indicates poorly managed blood sugars. There was also a large amount of blood in the urine and

bacteria was cultured. The patient had a high WBC level (12.67 K/uL), high % Neuts (93.8%),

high absolute neuts (11.88 K/uL), low % Lymphs (2.5%) and low absolute lymphs (0.31 K/uL).

This indicates acute infection rather than a chronic infection. With subsequent labs, these values

have shown steady improvement. The most recent results show that the WBC count is within

normal limits, the % Neuts are only slightly high. The % Lymphs are still low at 14.9%, but this

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value has improved quite a bit. The RBC, HGB and HCT have all fallen slightly below normal

ranges in the last labs. This could be explained by the body’s response to the anti-infective agent

given to kill the causative organism of the pyelonephritis.

The treatment of pyelonephritis requires that a culture and sensitivity be done to determine the

causative organism. Appropriate anti-infectives are then administered to the patient. Recovery

from pyelonephritis is usually relatively quick after appropriate treatment.

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References

Pyelonephritis. (2008). Pyelonephritis. In Wikipedia [Web]. San Fransisco: Wikipedia

Foundation. Retrieved April 7, 2008, from http://en.wikipedia.org/wiki/Pyelonephritis

Charytan, MD, MSc, D (2006). Kidney infection (pyelonephritis). In MedlinePlus [Web].

Bethesda: U.S. National Library of Medicine. Retrieved April 7, 2008, from

http://www.nlm.nih.gov/medlineplus/ency/article/000522.htm