Pyelonephritis

Two common laboratory tests are performed to diagnose kidney infections (pyelonephritis). A urine sample is examined under a microscope to determine if white and/or red blood cells are present. The urine is also sent to the lab to see if bacteria grow in a urine culture. If a person is very sick, blood cultures may also be sent. The strain of bacteria that are cultured will determine the type of therapy used in your treatment.

Pyelonephritis can often be treated without X-ray studies, unless your doctor suspects there may be an addition problem. CT scans produce images of structures and organs and these scans are usually done without contrast (dye). A renal ultrasound may sometimes suffice for evaluation.

A physician will treat the disease based on his or her examination. He or she may start the patient on the standard treatment of a course of antibiotics before the lab tests results are available. The medication may change once the exact strain of bacteria is revealed by the lab tests.

If the treatment is effective, the patient should feel better in two to three days. If not, your healthcare provider will start looking for additional problems. Most antibiotic treatments last for 14 days and it is essential that patients take the pills as recommended for the full 14 days even though symptoms may disappear after a few days. The disappearance of symptoms does not mean all bacteria are killed. Some may remain and the infection may reappear.

There is also a concern that those bacteria that remain may develop resistance to the medication. For some reason the disease is more difficult to treat in men and they may have to take medication for up to six weeks. Patients with severe illness, those that have significant nausea and vomiting, high fevers, significant pain and signs of dehydration may be hospitalized for a few days while the antibiotics are administered intravenously. Urine samples are taken after about six weeks of treatment and examined to insure the bacterial infection is eradicated.