The main pathways of infection in the kidney: upward - from foci of chronic inflammation of female genitals, the lower urinary tract, colon; hematogenous - of inflammatory foci distant organs (mastitis, tonsillitis, boil or carbuncle, etc.). The cause of acute pyelonephritis are violations of hemodynamics or urodynamics in the kidney or upper urinary tract. Depending upon the passage of urine through the upper urinary tract, i.e. from the kidney to the pelvis and then the ureter, there are distinguished two types of this disease: non-obstructive acute pyelonephritis and obstructive. Obstructive acute pyelonephritis is caused by blockage of the ureter stone products of chronic kidney inflammation, with external compression by retroperitoneal fibrosis, tumor, enlarged lymph nodes and etc.
The symptoms are following:
intermittent high fever,
dehydration and thirst
intoxication symptoms: headache, malaise, fatigue
dyspeptic symptoms: loss of appetite, diarrhea, and sometimes abdominal pain, nausea, vomiting.
pain on the affected side, bearing the permanent, dull character, aggravated by movement and palpation;
Pasternatsky positive symptom: pain during effleurage on the lumbar region;
Urine analysis: characterized by pyuria or leucocyturia, the presence of bacteria and minor proteinuria, sometimes there can be microhematuria. A large number of red blood cells , gross hematuria, can be at the combination of acute pyelonephritis with renal colic, complicated by necrosis of renal papillae. Urine specific gravity in pyelonephritis usually remains normal. This is due to preserving the function of tubules and oliguria due to significant fluid loss through sweat and breathing, as well as increased production of nitrogenous wastes from the accelerated catabolism, which is typical for the fever of any origin.
Urine analysis by Addis-Kakowski, Nechiporenko, Hamburger's: detection in urine sediment a large number of white blood cells with a predominance of neutrophils as well as the presence of bacteria. The diagnosis is confirmed by the content of 50-100 thousand or more microbial cells in 1 ml of urine. If the bacteria is less, then it indicates extrarenal urinary infection.
Complete blood analysis reveales leukocytosis, leukocyte formula shift to the left, increasing the ESR.
A urine culture for discovery of bacterial species and their sensitivity to antibiotics.