Complaints & connections · borters.ch
Pyelonephritis
The urine culture belongs given before the first antibiotic is taken — and fever plus a stone is an emergency, not a case for waiting.
Also known as: pyelonephritis · ascending urinary tract infection · kidney infection
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Kidney infection almost always arises from below: bacteria travel up from the bladder through the ureter. The difference from a simple bladder infection is easy to recognise in everyday life — fever, chills, a clear sense of illness and a pain in the flank are added, often with nausea. Burning on passing water may be there but need not be. It belongs treated quickly, because the kidney itself is affected and scars can remain. One act decides the further course and is often forgotten: giving a urine sample for culture before the first antibiotic is taken. Only that way does one know afterwards which germ it is and what it responds to — and that is exactly what is needed if the fever does not fall within two to three days. Some situations tolerate no delay: a known stone disease, a pregnancy, only one working kidney, a weakened immune system, and when nothing can be kept down. In a man and with repeated episodes a cause belongs looked for as well, rather than only treating.
Midstream, cleanly caught, handed in before the first tablet is taken. Afterwards the sample is worthless — and if the fever does not fall, exactly the information that helps is missing.
If the fever has not fallen by then, something is wrong: the wrong germ, an obstruction to outflow or a collection of pus. Then imaging belongs with it and not more waiting.
Drink plenty and empty the bladder often, at night too. Both flush and are the one measure that genuinely helps during treatment.
This combination is not a question of hours but of at once. The outflow has to be relieved; without that even the right antibiotic does not reach the place.
Residual urine, an enlarged prostate or a narrowing are the commonest reasons. An ultrasound measurement after passing water takes two minutes and answers a great deal.
With several episodes a year it is no longer about the next course but about prevention: how much is drunk, emptying habits, the local treatment after the menopause, and the question of a cause in the urinary tract.
Kidney infection needs an antibiotic that reaches the kidney, and seven to fourteen days — not the three days of a simple bladder infection. The fever usually falls within forty-eight to seventy-two hours; if it stays, an obstruction to drainage is looked for.
Treatment lasts seven to fourteen days, not the three days of a simple bladder infection — the antibiotic must reach the kidney tissue. The fever usually falls within forty-eight to seventy-two hours; if it stays longer, an obstruction or an abscess is looked for. Pregnant women and people with a stone are treated differently. About two to three in a thousand women are affected each year; after repeated episodes the kidney is checked.
That is the boundary with a simple bladder infection. Fever above thirty-eight degrees with a sense of illness does not belong to a bladder infection and is treated differently.
A pain at the side of the back, below the ribs, clearly increased by light tapping. It usually sits on one side.
The one combination that is not waited out: a ureter that is blocked and infected at the same time is a urological emergency, because the outflow has to be relieved before antibiotics can reach the place at all.
Here treatment is earlier and more consistent, because the consequences for mother and child can be considerable. Even bacteria found without complaints are treated in this time.
Then a cause is looked for — residual urine, a narrowing, a stone, an enlarged prostate. Only treating without looking leads to the next round.
The decisive step, and before the first tablet. The culture names the germ and how it behaves towards antibiotics — everything that follows depends on it.
Clearly raised, unlike in a simple bladder infection. It also serves afterwards to follow the course if the fever does not fall as expected.
White cells and neutrophils rise. The value alone decides nothing but rounds out the picture and shows the severity.
Shows whether kidney function is suffering. A rise together with fever points to back pressure — and that has to be relieved before antibiotics can work at all.
A sufficient amount of urine across the day dilutes what would otherwise crystallise or irritate. Spread evenly it works better than in two large portions.
With reduced kidney function it rises and becomes dangerous for the heart rhythm; under water tablets it falls. In both directions it belongs measured and not guessed.
With low levels airway infections occur somewhat more often; correcting a deficiency makes sense, a high single dose during the infection does not act on it.
Cutting out calcium is the wrong route with stones: it binds oxalate already in the bowel. Calcium with the meal instead of between meals is the lever, not avoidance.
Needed by the defence cells. For lozenges at the start of a cold there are hints of a slightly shortened duration; at a high dose over months zinc lowers copper.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
The main reason pregnant women are especially affected: this hormone relaxes the ureters, and the growing womb presses in addition. The urine stands longer — that is the whole explanation.
With fever and vomiting the body loses fluid and urine becomes scant — exactly the opposite of what the kidney now needs. Drinking is part of the treatment here, not an accessory.
Helps flush the urinary tract.
Studied for preventing recurrent urinary infections, not for treating a kidney infection. That belongs treated with antibiotics — fever and flank pain are not a matter for home remedies.