Skip to main content

Pyelonephritis

Dana G. Carroll, BCGP, CDCES, BCPS, PharmD and Connie Leeper, MPH, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • A syndrome caused by infection of the renal parenchyma and/or renal pelvis, often producing localized flank/back pain combined with systemic symptoms, such as fever, chills, nausea a...

DIAGNOSIS

HISTORY

  • In adults

    • Fever; flank pain; nausea ± vomiting. Malaise, anorexia, myalgia. Dysuria, urinary frequency, urgency; Suprapubic discomfort; Mental status changes (older adults)

  • In infants a...

TREATMENT

  • ≤7 days of treatment is equivalent to longer regimens in adults (including those with bacteremia) without urogenital abnormalities (1).

  • IV antibiotics for inpatients who are toxic appearing ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Adults & Children: Patients treated in the outpatient setting should have follow-up at 48-72 hours to evaluate for improvement and consideration of further e...

REFERENCES

1
Kolman KB. Cystitis and Pyelonephritis: Diagnosis, Treatment, and Prevention. Prim Care. 2019;46(2):191-202. doi: 10.1016/j.pop.2019.01.001. PMID: 31030820

CODES

ICD10

  • N12 Tubulo-interstitial nephritis, not spcf as acute or chronic

  • N10 Acute tubulo-interstitial nephritis

  • N11.9 Chronic tubulo-interstitial nephritis, unspecified

  • N11.8 Other chronic tubulo-inte...

CLINICAL PEARLS

  • Urine culture is helpful for targeting antibiotic therapy and should be obtained when possible

  • Pyelonephritis can present with isolated confusion or mental status changes (no fever) in ...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×