(c) From an infection such as septicemia in which bacteria are carried
to the kidney by blood.
(d) From an inability to empty the bladder. Patients with tumors,
strictures, or benign hypertrophy cannot completely empty the bladder of urine.
Bacteria can grow in such an environment.
(2) Incidence of acute pyelonephritis. The incidence of acute pyelonephritis
is higher in these groups of people:
(a) Pregnant women. A small percentage of pregnant women develop
bacteriuria (bacteria in the urine). If this condition is not treated, about 40 percent of
these women develop pyelonephritis.
(b) Sexually active women. There is an increase in the possibility of
(c) Diabetic individuals. Some people with diabetes have a neurogenic
bladder, a disorder in which the bladder does not empty completely. Bacteria may,
then, grow in the urine.
(d) Individuals with other renal diseases. A person whose renal
function is not operating properly from other renal diseases has an increased risk of
(3) Signs and symptoms of acute pyelonephritis. The signs and symptoms
of pyelonephritis may be absent or obscured by an associated disease. If signs and
symptoms are present, the following are typical:
(a) Urgency, frequency, and burning during urination.
(b) Urine with a fishy odor and cloudy appearance.
Back and flank pain over one or both kidneys, caused by edema.
Chills, fever (102 F or higher), nausea, and vomiting.
Protein and casts on urinalysis.
These symptoms may develop either over a few hours or over a few days.
Even without treatment, the symptoms may disappear in a few days, but there
may still be a bacterial infection. If so, the symptoms may reappear later.