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Pyelonephritis

Kidneys, ureters, bladder, and urethra are the main components of the urinary tract system. Any part of the urinary system may become infected and this is generally referred to as urinary tract infection (UTI). When a kidney becomes infected, the condition is medically referred to as pyelonephritis. Pyelonephritis is caused by bacteria which gain access to the urinary system from outside through the urethra and, thus, leads to the UTI.

Pyelonephritis is an ascending urinary tract infection that has reached the pelvis of the kidney. Severe cases of pyelonephritis can lead to the following complications: pyonephrosis (pus accumulation around the kidney), urosepsis (a systemic inflammatory response of the body to infection), kidney failure and even death.

Usually, pyelonephritis manifests itself with such symptoms as: fever, accelerated heart rate, painful urination, abdominal pain radiating to the back, nausea, and tenderness at the costovertebral angle on the affected side.

Classification. Pyelonephritis can be acute, chronic or xanthogranulomatous.

Acute pyelonephritis is an exudative purulent localized inflammation of the renal pelvis and kidney. Gross pathology often reveals pathognomonic radiations of bleeding and suppuration through the renal pelvis to the renal cortex.

Chronic pyelonephritis implies recurrent kidney infections, and can result in scarring of the renal parenchyma and impaired function. A perinephric abscess (infection around the kidney) and/or pyonephrosis may develop in severe cases of pyelonephritis.

Xanthogranulomatous pyelonephritis is an unusual form of chronic pyelonephritis characterized by granulomatous abscess formation and severe kidney destruction. A clinical picture may resemble renal cell carcinoma and other inflammatory renal parenchymal diseases. Most patients complain of recurrent fevers and urosepsis, anemia, and a painful renal mass. Other common manifestations include kidney stones and loss of function of the affected kidney.

To determine pyelonephritis the following examinations are necessary to make: urinalysis to show the signs of urinary tract infection (UTI); a urine test strip to reveal the presence of nitrite and white blood cells; blood tests; microbiological culture of the urine and antibiotic sensitivity testing.

Pyelonephritis requires antibiotic therapy, and sometimes surgical intervention such as percutaneous nephrostomy or percutaneous nephrolithotomy, as well as treatment of any underlying causes to prevent its recurrence.

Exercise 5. Answer the questions:

1. What is pyelonephritis?

2. What can it lead to?

3. What are the symptoms of pyelonephritis?

4. What is the cause of pyelonephritis?

5. What are the types of pyelonephritis?

6. How does acute pyelonephritis manifest itself?

7. What can chronic pyelonephritis result in?

8. What is the clinical picture of xanthogranulomatous pyelonephritis?

9. What examinations are necessary to make to determine pyelonephritis?

10. How is pyelonephritis treated?

Exercise 6. Give the English equivalents:

висхідна сечова інфекція, потрапляти з оточуючої середи, нагноєння навколо нирки, серйозні випадки пієлонефриту, болісне сечовипускання, черевний біль, уражений бік, гнійне локалізоване запалення, втрата функції, значна деструкція нирки, лікування антибіотиками, хірургічне втручання.

Exercise 7. Match the corresponding pairs:

Exercise 8. Find synonyms to the following words:

Exercise 9. Fill in the table:

Exercise 10. Match the following symptoms of the UTI with their definitions:

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