Pyelonephritis is an upper urinary tract infection, which is an infection affecting the upper urinary tract, which are the kidneys and renal pelvis. The latter is also called pyelon, while nephrology refers to the study of the kidney, hence the name chosen to designate the urinary tract infection of these two anatomical parts.
Note that pyelonephritis is a serious infection that can destroy the kidney, where the lower urinary tract infection, or cystitis, is generally not serious. However, the latter can develop into pyelonephritis if it is not (or poorly) taken care of.
There are also two forms of pyelonephritis:
- acute pyelonephritis, called “of the adult”, which is often the consequence of a lower urinary tract infection which has spread;
- chronic pyelonephritis, which occurs more in babies and which may be linked to anatomical abnormalities (vesicoureteric reflux in particular).
Symptoms of pyelonephritis in babies
If in the “big” child, the symptoms are identical to those of the adult (fever, back pain, signs of cystitis, digestive disorders), the symptoms of pyelonephritis in infants or toddlers are misleading.
Pyelonephritis can then manifest as:
- unexplained fever;
- urine of an unusual color or odor;
- crying while urinating;
- the presence of blood in the urine;
- loss of appetite, refusal of the bottle;
- vomitings;
- diarrhea;
- mood change and fatigue, irritability, moaning;
- weight loss;
- abdominal pain.
However, an infant with pyelonephritis will not necessarily have all of these symptoms at the same time, making it difficult to spot such an infection. An isolated fever should particularly push to consult quickly.
Pyelonephritis in babies: how is it diagnosed?
In the event of symptoms suggestive of pyelonephritis in babies, the doctor will proceed to start the urine dipstick test. An examination that can be done simply by applying the strip to a compress soaked in the baby’s urine, taken from his diaper.
If the test strip is positive and indicates the presence of a bacterial infection, a cytobacteriological examination of the urine, or ECBU, will be performed in the laboratory. It will allowidentify the germ in question to better target it by antibiotic treatment.
In babies and adults alike, the treatment of pyelonephritis most often relies on the prescription of antibiotics. As the results of ECBU are not immediate, broad-spectrum antibiotics are often prescribed, then treatment is changed to better target the causative germs. In a newborn less than three months old, antibiotic therapy is given intravenously, which implies hospitalization for a few days.
Finally, in young children, the occurrence of one (or more) cystitis, or even pyelonephritis, should lead to perform an ultrasound to diagnose a possible malformation, such as vesicoureteral reflux or pyelo-ureteral junction syndrome. These two abnormalities of the urinary system can indeed be the cause of pyelonephritis in the baby. If these abnormalities do not go away on their own after antibiotic treatment, surgery may be necessary.