Chronic Pyelonephritis

? Complex disorder: bacterial infection + other factors (vesicoureteral reflux,

obstruction)
? Causes: Escherichia coli, followed by Proteus, Klebsiella, and Enterobacter. S
treptococcus faecalis, also of enteric origin, staphylococci, and virtually ever
y other bacterial and fungal agents
? Routes of spreading:
o through the blood-stream (hematogenous infection) ? less common. In sepsis & I
E
o from the lower urinary tract (ascending infection)