Pyelonephritis

2001, Jeffery Hughes, 12: Infectious Diseases, N. A. Hughes, Clinical Pharmacy, Macmillan Health, 2nd Edition, page 215, Primary acute pyelonephritis most commonly occurs in females, with 90% of cases caused by Escherichia coli.

The urinogenous or ascending nephropathies are divisible into two great groups (a) the hydronephrotic nephropathies and (b) the pyelonephritides.

The frequent spontaneous resolution of cystopyelic reflux after 10 years of age induces to consider at least part of the apparently primary pyelonephritides as secondary to yet disappeared refluxes and, thus, to allocate in this group most of the so-called atrophic pyelonephritides of the young, often monolateral or mostly affecting one kidney, with sterile urine and almost normal urinary sediment.

The kidneys of acute pyelonephritis have small white abscesses on the subcapsular surface and on cut surfaces.

Pyelonephritis is most commonly encountered in younger, nulliparous women in their second trimester. Women with a history of pyelonephritis, renal calculi or anatomic malformations are particularly susceptible to the development of pyelonephritis and should therefore be regularly screened on a monthly basis throughout pregnancy.