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    Acute pyelonephritis is a serious bacterial infection common in infants under 24 months presenting with fever without an obvious source. Risk factors include anatomical abnormalities, poor hygiene, constipation, and sexual activity. Symptoms include fever over 39°C, abdominal or flank pain, malaise, and occasionally diarrhea. Diagnosis is based on symptoms, urinalysis showing nitrites or leukocyte esterase, and urine culture. Complications can include renal or perinephric abscesses, acute renal failure, and sepsis. Treatment involves antibiotics like cefotaxime plus amikacin for those under 2 months or co-amoxiclav for those over 2 months, for 7-14 days.

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    Acute pyelonephritis is a serious bacterial infection common in infants under 24 months presenting with fever without an obvious source. Risk factors include anatomical abnormalities, poor hygiene, constipation, and sexual activity. Symptoms include fever over 39°C, abdominal or flank pain, malaise, and occasionally diarrhea. Diagnosis is based on symptoms, urinalysis showing nitrites or leukocyte esterase, and urine culture. Complications can include renal or perinephric abscesses, acute renal failure, and sepsis. Treatment involves antibiotics like cefotaxime plus amikacin for those under 2 months or co-amoxiclav for those over 2 months, for 7-14 days.

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    2 views1 page

    Acute Pyelonephritis 022022

    Uploaded by

    rheamae.resurreccion
    Acute pyelonephritis is a serious bacterial infection common in infants under 24 months presenting with fever without an obvious source. Risk factors include anatomical abnormalities, poor hygiene, constipation, and sexual activity. Symptoms include fever over 39°C, abdominal or flank pain, malaise, and occasionally diarrhea. Diagnosis is based on symptoms, urinalysis showing nitrites or leukocyte esterase, and urine culture. Complications can include renal or perinephric abscesses, acute renal failure, and sepsis. Treatment involves antibiotics like cefotaxime plus amikacin for those under 2 months or co-amoxiclav for those over 2 months, for 7-14 days.

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    of 1

    ACUTE PYELONEPHRITIS

    MOST COMMON SERIOUS BACTERIAL INFECTION IN


    INFANTS YOUNGER THAN 24 MONTHS OF AGE WHO
    HAVE FEVER WITHOUT AN OBVIOUS FOCUS.

    RISK FACTORS
    WIPING FROM BACK TO FRONT (GIRLS) ANATOMIC ABNORMALITY (LABIAL ADHESION)
    URETHRAL INSTRUMENTATION TIGHT CLOTHING (UNDERWEAR)
    VESICOURETERAL REFLUX BACTERIA WITH FIMBRIAE
    OBSTRUCTIVE UROPATHY NEUROPATHIC BLADDER
    VOIDING DYSFUNCTION PINWORM INFESTATION
    UNCIRCUMCISED MALE SEXUAL ACTIVITY
    TOILET TRAINING CONSTIPATION
    FEMALE GENDER PREGNANCY
    BUBBLE BATH

    FEVER > 39°C


    MALAISE
    WITHOUT ANOTHER SOURCE
    ABDOMINAL, BACK LASTING > 24 HR FOR MALES NAUSEA AND VOMITING
    OR FLANK PAIN AND > 48 HR FOR FEMALES OCCASIONALLY DIARRHEA

    SIGNS AND SYMPTOMS


    IF YOUR CHILD HAVE ANY SYMPTOMS STATED ABOVE,
    CONSULT YOUR PEDIATRICIAN IMMEDIATELY.

    HOW TO DIAGNOSE COMPLICATIONS


    BASED ON SYMPTOMS OR FINDINGS ON URINALYSIS
    OR BOTH A URINE CULTURE RENAL OR PERINEPHRIC ACUTE RENAL FAILURE
    ABSCESS FORMATION

    NITRITES AND LEUKOCYTE ESTERASE

    EMPHYSEMATOUS PAPILLARY NECROSIS


    COMPLETE BLOOD COUNT PYELONEPHRITIS

    RENAL VEIN THROMBOSIS SEPSIS

    HOW TO OBTAIN SAMPLE


    TOILET- TRAINED CHILDREN
    MIDSTREAM URINE SAMPLE USUALLY IS
    SATISFACTORY; THE INTROITUS SHOULD BE
    CLEANED BEFORE OBTAINING THE SPECIMEN
    UNCIRCUMCISED MALES GOLD STANDARD
    PREPUCE MUST BE RETRACTED; IF THE PREPUCE IS
    NOT RETRACTABLE, A VOIDED SAMPLE MAY BE
    UNRELIABLE AND CONTAMINATED WITH SKIN CORTICAL SCINTIGRAPHY WITH TC-99M DMSA
    FLORA MOST FREQUENTLY, CORTICAL SCANNING IS DONE IN
    CHILDREN 2- 24 MONTHS CHILDREN WITH ACUTE PYELONEPHRITIS.
    IN CHILDREN WHO ARE NOT TOILET TRAINED, A
    CATHETERIZED OR SUPRAPUBIC ASPIRATE URINE URINE CULTURE
    SAMPLE SHOULD BE OBTAINED

    DRUG OF CHOICE
    ACUTE UNCOMPLICATED UTI: ACUTE CYSTITIS AND PYELONEPHRITIS
    < 2 MONTHS: CEFOTAXIME PLUS AMIKACIN FOR 10- 14 DAYS
    > 2 MONTHS TO 18 YEARS OLD: CO- AMOXICLAV, CEFUROXIME, AMPICILLIN- SULBACTAM FOR 7- 14 DAYS
    NITROFURANTOIN CAN BE GIVEN FOR ADOLESCENTS

    REFERENCES
    Submitted by:
    Ayop, Boiser, Carcueva, Castroverde, Esleta, Estanda, Galas, Garcia, Lastimosa,
    Kliegman, R. (2020). Urinary Tract Infection. In Nelson Textbook of Pediatrics (pp. 10952–10954). essay, Elsevier. Maraki, Maravilla, Resurreccion, Sarpamones, Seniel, and Villamor
    JL;, C. C. M. L. (n.d.). Diagnosis and treatment of urinary tract infections across age groups. American journal of obstetrics and gynecology. Retrieved Submitted to:
    from https://pubmed.ncbi.nlm.nih.gov/29305250/#:~:text=Urine%20culture%20is%20the%20gold,not%20be%20treated%20with%20antibiotics. Department of Pediatrics
    February 20, 2022

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