Title: Study of Epidemiological, Clinical, Laboratory Profile and Outcomes of Acute Pyelonephritis in a Tertiary Care Hospital of North Andhra Pradesh

Authors: Dr Tati Hyma, Dr YG Sundara Raju, Dr Marri Lakshmi Harika, Dr Gadipudi Mounika

 DOI: https://dx.doi.org/10.18535/jmscr/v8i11.35

Abstract

Background: Acute pyelonephritis is a severe form of urinary tract infection with symptoms that range from mild discomfort to life threatening illness or death. Complications may result in chronic renal scarring and renal function impairment, leading to more significant morbidity in patients with a pre-existing structural or functional renal defect.

Materials and Methods: This is a prospective observational study done for eight months in the Department of General Medicine, King George Hospital, Visakhapatnam, from January 2020 to August 2020. A total of 40 patients with a diagnosis of acute pyelonephritis were followed up for this study

Results: Out of the 40 patients, 26 were male, and 14 were female. Renal dysfunction at presentation was seen in 28 patients. Urine culture was positive in 11 patients, with E.coli being the most common organism isolated. Ultrasound abdomen was suggestive of pyelonephritis in only 32 patients.

Conclusion: Acute pyelonephritis causes high morbidity and mortality and may even lead to chronic renal dysfunction. The absence of a positive urine culture does not rule out acute pyelonephritis. In a patient with high clinical suspicion of pyelonephritis and ultrasound abdomen does not reveal any abnormalities, CT abdomen should be performed to rule out the disease.

References

  1. Czaja CA, Scholes D, Hooton TM, Stamm WE: Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis. 2007, 45:273-280. 10. 1086/519268
  2. Stone SC, Mallon WK, Childs JM, Docherty SD. Emphysematous pyelonephritis: clues to rapid diagnosis in the Emergency Department. J Emerg Med. 2005 Apr;28(3):315-9.
  3. Umesha L, Shivaprasad SM, Rajiv EN, et al. Acute Pyelonephritis: A Single-center Experience. Indian J Nephrol. 2018;28(6): 454-461. doi:10.4103/ijn.IJN_219_16
  4. Georgi Abraham, Yuvaram N.V. Reddy, Gautam George. Nephrology Dialysis Transplantation, Volume 27, Issue 9, September 2012, Pages 3391-3394.
  5. Kumar S, Ramachandran R, Mete U, et al. Acute pyelonephritis in diabetes mellitus: single center experience. Indian J Nephrol. 2014;24:367–71
  6. Patel HB, Soni ST, Bhagyalaxmi A, Patel NM. Causative agents of urinary tract infections and their antimicrobial susceptibility patterns at a referral center in Western India: An audit to help clinicians prevent antibiotic misuse. J Family Med Prim Care. 2019;8(1):154-159. doi:10.4103/jfmpc.jfmpc_203_18
  7. Kalyanakrishnan Ramakrishnan, M.D., and Dewey C. Scheid, M.D., M.P.H., University of Oklahoma Health Sciences CenterOklahoma CityOklahoma Am Fam Physician.2005 Mar 1;71(5):933-942.

Corresponding Author

Dr Tati Hyma

Post Graduates, Department of General Medicine, King George Hospital, Visakhapatnam, Andhra Pradesh, India