Causes of inflammation of the renal pelvis
It is often caused by the bacteria E. coli, Proteus or Klebsiella.
Symptoms of inflammation of renal pelvis
One or two-sided flank pain develops, which can also extend into the groin or scrotum. Those affected complain of high fever up to 40° C with chills, severe feeling of illness, weakness, loss of appetite and nausea. If cystitis (inflammation of the bladder) exists at the same time, there is pain when urinating (dysuria), frequent urination (pollakiuria) and bladder cramps. There may also be a change in the urine. This can appear cloudy to flaky, and blood in the urine is also possible.
Diagnosis of inflammation of renal pelvis
First of all, the patient should keep a strict bed rest and drink plenty of fluids. Antibiotics should be used immediately after taking a urine culture (urine test for bacteria) and before the results are obtained. For eight days, so-called broad-spectrum antibiotics (e.g. cephalosporins) are then recommended.
Broad-spectrum antibiotics are effective against many types of bacteria. If the fever still cannot be reduced, the patient should visit a clinic, as complications must be considered. If the acute complaints have disappeared and the results of the urine culture are available, i.e. the bacterium (germ) is known, the patient should switch to an appropriate antibiotic.
Treatment is continued until the urine results are normal and no more bacteria can be detected in the urine culture. Checks and follow-up examinations after several months are recommended. In case of non-response or repeated (recurrent) infections, a complicated inflammation of the renal pelvis should be considered (see below).
If detected and treated in time, the prognosis of primary acute inflammation of the renal pelvis is good. It usually heals without consequences. In contrast to the primary form, secondary pelvic inflammatory disease is associated with risk factors (see above) that can trigger or maintain inflammation.
These include flow disorders or congestion in the urinary tract. It is a severe clinical picture with high fever, chills and severe flank pain. Severe complications such as abscess formation or urosepsis (blood poisoning) can occur.
The affected kidney is very sensitive to pain. A dry or brownish, brittle tongue is noticeable. The urine itself contains many white blood cells, bacteria and protein.
The above-mentioned drainage disorders must be clarified by means of X-ray, ultrasound or urogram (see above). This disease should always be treated in a clinic. Since the cause is usually a congestion, antibiotic therapy can help little, since it does not eliminate the cause.
In case of severe complications, it may even be necessary to remove the affected kidney (nephrectomy). Without correction of the underlying defect, repeated secondary pelvic inflammation of the renal pelvis may occur.
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