Pyelonephritis Diagnostics and Laboratory Tests

Symptoms of pyelonephritis might vary and can include painful urination, chills, and fever; two of the mentioned symptoms the patient confirmed to have. I would advise the patient to drink liquids to flush bacteria from the urinary tract but only if they do not have kidney failure (NIH, 2017).

Medical professionals should also take in consideration that pregnant women who have pyelonephritis are more likely to be 29 years old or younger, Hispanic or black, nulliparous, and less educated (Wing, Fasset, & Getahun, 2014). Perinatal outcomes for pregnant women with pyelonephritis include anemia, spontaneous preterm birth, and primary cesarean.

In case if the medical professional suspects APN but no predisposing condition can be found via ultrasound, non-complicated APN is suspected. CT and MRI can be used in this case to examine possible inflammatory areas and any evidence of abscesses (De Pascale et al., 2013). Imaging techniques allow the professional to evaluate the severity of kidney involvement, as well as look for any previous abnormalities that can lead to life-threatening conditions in patients with autoimmune diseases (e.g. diabetes) or elderly individuals.

It should also be noted that “pyuria defined as white blood cell (WBC) count ≥10 in a high power field in urinalysis; and leukocytosis defined as WBC count ≥20,000/mm3 or polymorphonuclear cell count ≥ 65% in peripheral blood tests” can also indicate APN, although the patient should also discuss the frequency of urination and possible flank pain/fever with the medical professional (Kim et al., 2017, p. 25). Thus, not only the ultrasound (or CT/MRI) but also blood tests should be used for the diagnosis of APN.

References

De Pascale, A., Piccoli, G. B., Priola, S. M., Rognone, D., Consiglio, V., Garetto, I., & Veltri, A. (2013). Diffusion-weighted magnetic resonance imaging: New perspectives in the diagnostic pathway of non-complicated acute pyelonephritis. European Radiology, 23(11), 3077-3086.

Kim, Y., Seo, M. R., Kim, S. J., Kim, J., Wie, S. H., Cho, Y. K., & Cheong, H. J. (2017). Usefulness of blood cultures and radiologic imaging studies in the management of patients with community-acquired acute pyelonephritis. Infection & Chemotherapy, 49(1), 22-30.

NIH. (2017). Web.

Wing, D. A., Fassett, M. J., & Getahun, D. (2014). Acute pyelonephritis in pregnancy: An 18-year retrospective analysis. American Journal of Obstetrics and Gynecology, 210(3), 219-231.

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