Kidney Infections: Symptoms and Treatments
How Pyelonephritis Is Diagnosed continued...
Urine culture. Within days, bacteria in urine may grow on a culture dish, allowing the best antibiotic to be chosen.
Blood cultures. If pyelonephritis has spread to the blood, blood cultures can detect this and guide treatment.
Computed tomography (CT scan). A scanner takes a rapid series of X-rays, and a computer creates detailed images of the abdomen and kidneys. A CT scan is not necessary to diagnose pyelonephritis, but sometimes helps.
Kidney ultrasound. A probe directs high-frequency sound waves through the skin, creating images of the kidneys and ureters. Ultrasound can help identify abscesses, stones, and blockages.
In addition to diagnosing pyelonephritis itself, doctors look for any conditions that make pyelonephritis more likely. For example, kidney stones or birth defects of the urinary tract can increase the chance of an infection. Both are potentially correctable, which will reduce the chances of future kidney infections.
Treatment of Pyelonephritis
Pyelonephritis is a serious infection that always requires treatment with antibiotics. Home remedies alone aren't effective or recommended for pyelonephritis.
For most cases of pyelonephritis, hospitalization isn't required. Home treatment is appropriate if a person is able to get around and can consistently take oral antibiotics. For example, they must not be confined to bed or regularly vomiting.
Hospitalization is required to treat more severe pyelonephritis, however. Delivering antibiotics intravenously in the hospital ensures that the medicine is reaching the kidneys.
Antibiotics are generally prescribed for a total of at least seven days. Part of this course of treatment may be given in the hospital intravenously; the remainder of the treatment may be taken at home in the form of pills.
In rare cases, pyelonephritis may progress to form a pocket of infection (abscess). Abscesses are difficult or impossible to cure with antibiotics alone and must be drained. Most often, this is done with a tube inserted through the skin on the back into the kidney abscess (a procedure called a nephrostomy).
Acute and Chronic Pyelonephritis
Most cases of pyelonephritis are acute, meaning sudden and self-limited. After cure with antibiotics, there is rarely any lasting damage to the kidneys. Most people do not develop pyelonephritis again.
Chronic (long-lasting) pyelonephritis is a rare condition, usually caused by birth defects in the kidney. Repeated UTIs (usually in children) result in progressive damage and scarring in the kidney. This can eventually cause kidney failure. Usually, chronic pyelonephritis is discovered in childhood.