Understanding pyelonephritis

急性肾盂肾炎是突然和严重的肾脏感染。它导致肾脏膨胀，可能会永久损坏它们。肾盂肾炎可能是危及生命的。

When repeated or persistent attacks occur, the condition is called chronic pyelonephritis. The chronic form is rare, but it happens more often in children or people with urinary obstructions.

Symptoms usually appear within two days of infection. Common symptoms include:

其他症状可以包括：

  • 摇晃或寒冷
  • nausea
  • 呕吐
  • general aching or ill feeling
  • 疲劳
  • 水润的肌肤
  • mental confusion

Symptoms may be different in children and older adults than they are in other people. For example, mental confusion is common in older adults and is often their only symptom.

患有慢性肾盂肾炎的人们可能只会体验轻微的症状，或者甚至完全缺乏明显的症状。

The infection usually starts in the lower urinary tract as a尿路感染（UTI）。Bacteria enter the body through the urethra and begin to multiply and spread up to the bladder. From there, the bacteria travel through the ureters to the kidneys.

Bacteria such as大肠杆菌经常引起感染。然而，血液中的任何严重感染也可以扩散到肾脏并导致急性肾盂肾炎。

急性肾盂肾炎

任何问题,中断正常流动的urine causes a greater risk of acute pyelonephritis. For example, a urinary tract that’s an unusual size or shape is more likely to lead to acute pyelonephritis.

Also, women’s urethras are much shorter than men’s, so it’s easier for bacteria to enter their bodies. That makes women more prone to kidney infections and puts them at a higher risk of acute pyelonephritis.

Other people who are at increased risk include:

  • anyone with chronic kidney stones or other kidney or bladder conditions
  • older adults
  • people with suppressed immune systems, such as people withdiabetes那HIV爱滋病那or cancer
  • 具有vesicoureteral回流的人（一种少量尿液从膀胱备份到输尿管和肾脏的条件）
  • people with an前列腺肥大

可以让你容易感染的其他因素包括：

Chronic pyelonephritis

条件的慢性形式在患有泌尿障碍物的人中更常见。这些可能是由UTIS，vesicourallal回流或解剖异常引起的。慢性肾盂肾炎在儿童中比成年人更常见。

Urine tests

医生将检查发烧，腹部温柔，以及其他常见症状。如果他们怀疑肾脏感染，他们会命令尿检。这有助于他们检查尿液中的细菌，浓度，血液和脓液。

Imaging tests

医生还可以命令超声检查尿路中的囊肿，肿瘤或其他障碍物。

对于在72小时内没有回应治疗的人，aCT扫描(with or without injectable dye) may be ordered. This test can also detect obstructions within the urinary tract.

Radioactive imaging

如果您的医生怀疑由于肾盂肾炎的瘢痕出现，则可以命令二巯基琥珀酸（DMSA）测试。这是一种追踪注射放射性物质的成像技术。

医疗保健专业人员通过手臂中的静脉注入材料。然后材料行进肾脏。随着放射性物质通过肾脏显示的图像显示被感染或伤痕累累的区域。

Antibiotics

抗生素是反对急性肾盂肾炎的第一种行动方针。然而，您的医生选择的抗生素类型取决于是否可以识别细菌。如果没有，使用广谱抗生素。

虽然药物可以在2至3天内治愈感染，但必须对整个处方期进行药物（通常10至14天）。即使你感觉更好，这也是如此。

The antibiotic options are:

  • levofloxacin
  • ciprofloxacin
  • co-trimoxazole
  • ampicillin

Hospital admission

In some cases, drug therapy is ineffective. For a severe kidney infection, your doctor may admit you to the hospital. The length of your stay depends on the severity of your condition and how well you respond to treatment.

治疗可包括静脉内水合和抗生素24-48小时。当你在医院时，医生会监测你的血液和尿液以跟踪感染。从医院释放后，你可能会收到价值10到14天的口腔抗生素。

手术

Recurrent kidney infections may result from an underlying medical problem. In those cases, surgery may be required to remove any obstructions or to correct any structural problems in the kidneys. Surgery may also be necessary to drain an abscess that doesn’t respond to antibiotics.

在严重感染的情况下，a肾切除术may be necessary. In this procedure, a surgeon removes part of the kidney.

怀孕导致身体的许多暂时变化，包括泌尿道的生理变化。孕酮增加和输尿管的增加的压力可能导致肾盂肾炎的风险增加。

孕妇的肾盂肾炎typically requires hospital admission. It can threaten the lives of both mother and baby. It can also increase the risk of premature delivery. Pregnant women are treated with beta-lactam antibiotics for at least 24 hours until their symptoms improve.

To prevent pyelonephritis in pregnant women, a urine culture should be conducted between the 12th and 16th weeks of pregnancy. A UTI that doesn’t have symptoms can lead to the development of pyelonephritis. Detecting the UTI early can prevent kidney infection.

According to the美国泌尿学协会，在美国，每年为儿科医生提供超过一百万的旅行，用于儿科医生进行儿科宿舍。如果超过一岁，女孩会增加风险。如果在一个人下，男孩的风险更大，特别是如果他们是未被处理的。

Children with UTIs often have fever, pain, and symptoms related to the urinary tract. A doctor should address these symptoms immediately before they can develop into pyelonephritis.

Most children can be treated with oral antibiotics in an outpatient manner.了解有关孩子们的utis。

A possible complication of acute pyelonephritis is chronic kidney disease. If the infection continues, the kidneys may be permanently damaged. Although rare, it’s also possible for the infection to enter the bloodstream. This can result in a potentially deadly infection calledsepsis。

Other complications include:

Pyelonephritis can be a serious condition. Contact your doctor as soon as you suspect that you have pyelonephritis or a UTI. This condition requires prompt medical attention, so the earlier you start treatment, the better.