Pyelonephritis is inflammation of the kidney, typically due to a bacterial infection.[3] Symptoms most often include fever and flank tenderness.[2] Other symptoms may include nausea, burning with urination, and frequent urination.[2] Complications may include pus around the kidney, sepsis, or kidney failure.[3]

It is typically due to a bacterial infection, most commonly Escherichia coli.[2] Risk factors include sexual intercourse, prior urinary tract infections, diabetes, structural problems of the urinary tract, and spermicide use.[2][3] The mechanism of infection is usually spread up the urinary tract.[2] Less often infection occurs through the bloodstream.[1] Diagnosis is typically based on symptoms and supported by urinalysis.[2] If there is no improvement with treatment, medical imaging may be recommended.[2]

Pyelonephritis may be preventable by urination after sex and drinking sufficient fluids.[1] Once present it is generally treated with antibiotics, such as ciprofloxacin or ceftriaxone.[4][6] Those with severe disease may require treatment in hospital.[2] In those with certain structural problems of the urinary tract or kidney stones, surgery may be required.[1][3]

Pyelonephritis is common.[5] About 1 to 2 per 1,000 women are affected a year and just under 0.5 per 1,000 males.[7] Young adult females are most often affected, followed by the very young and old.[2] With treatment, outcomes are generally good in young adults.[3][5] Among people over the age of 65 the risk of death is about 40%.[5]


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