Acute Pyelonephritis – Complicated UTIs

00:01 So let's move on to our complicated urinary tract infections and included in this is acute pyelonephritis.

00:08 Prostatitis, catheter associated infection, Emphysematous pyelonephritis, and xanthogranulomatous pyelonephritis.

00:18 So let's talk about acute pyelonephritis, which is what our patient had.

00:22 The symptoms include fever greater than 38 degrees.

00:26 Chills, flank in abdominal pain, nausea and emesis.

00:30 Patients may or may not have symptoms of cystitis Those are those irritate avoiding symptoms that we talked about before.

00:37 The presentations can vary from very mild to sepsis with renal failure.

00:42 Diagnosis and treatment is really going to depend on our urine analysis a urine culture and sensitivity.

00:48 Treatment is important to think about in this particular population.

00:51 There are indications for hospitalization and we have to be cognizant of that.

00:56 So if a patient persistently has high fever greater than 38 4 celcius, inability to maintain oral hydration, or take oral medications or marketability that's going to be an indication for inpatient admission.

01:11 Antimicrobial therapy is going to consist of if patient can be treated outpatient oral fluoroquinolones.

01:19 Inpatient treatment is going to conclude drugs like ceftriaxone.

01:24 If pseudomonal coverage is needed we can use piperacillin-tazobactum, cefepime or cept a city or a fluoroquinolone.