{"id":2818,"date":"2021-04-02T08:00:00","date_gmt":"2021-04-02T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=2818"},"modified":"2026-08-27T20:41:35","modified_gmt":"2026-08-27T13:41:35","slug":"%ea%b8%89%ec%84%b1-%ec%8b%a0%ec%9a%b0%ec%8b%a0%ec%97%bc","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/ko\/2021\/04\/02\/acute-pyelonephritis\/","title":{"rendered":"Kidney Infection (Acute Pyelonephritis): When Antibiotics Are Not Enough"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ko\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Best Urologist working in Chonburi and Cambodia\" class=\"wp-image-7037\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=768%2C768&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=12%2C12&amp;ssl=1 12w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=600%2C600&amp;ssl=1 600w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=400%2C400&amp;ssl=1 400w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=200%2C200&amp;ssl=1 200w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:75%\">\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/drsoaraweeurology.com\/\" target=\"_blank\" rel=\"noreferrer noopener\">Soarawee Weerasopone, Urologist<\/a><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Bangkok hospital Headquarter, Bangkok<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"tel:+66880221445\" target=\"_blank\" rel=\"noreferrer noopener\">Samitivej Sriracha Hospital \u2014 Urology department: <strong>088-022-1445<\/strong><\/a><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link has-background-background-color has-text-color has-background has-link-color has-small-font-size has-custom-font-size wp-element-button\" href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" style=\"color:#1b4965\" target=\"_blank\" rel=\"noreferrer noopener\">Book a Consultation<\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<ul class=\"wp-block-social-links aligncenter has-normal-icon-size is-style-default 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2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">A kidney infection is a bladder infection that has climbed. It is far more serious than the cystitis it usually starts as, and it is one of the conditions in urology where the difference between a good outcome and a disaster is measured in hours.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you have fever with flank pain<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Get seen today.<\/strong> Not with a leftover antibiotic from a previous episode, and not by waiting to see whether it settles overnight. In an emergency in Thailand, call <strong>1669<\/strong>. Go to hospital immediately rather than to a clinic if any of the following are present:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Confusion, drowsiness, or feeling profoundly unwell<\/strong> in a way that is different from ordinary illness.<\/li>\n\n\n\n<li><strong>Shaking chills, rapid breathing, a racing pulse, or feeling faint on standing.<\/strong><\/li>\n\n\n\n<li><strong>Passing very little or no urine.<\/strong><\/li>\n\n\n\n<li><strong>Vomiting so much you cannot keep fluids or tablets down.<\/strong><\/li>\n\n\n\n<li><strong>Known kidney stones, a ureteric stent, one kidney, or a kidney transplant.<\/strong><\/li>\n\n\n\n<li><strong>Pregnancy<\/strong>, at any severity.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Urology center Bangkok hospital Thailand\u00a0<a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Booking online<\/a>\u00a0<a href=\"tel:02-310-3009\">02-310-3009<\/a>\u00a0<a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a><\/li>\n\n\n\n<li>Samitivej Sriracha hospital Chonburi&nbsp;<a href=\"tel:088-022-1445\">088-022-1445<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">The distinction that matters most: is the kidney also blocked?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This was absent from the earlier version of this article entirely, and it is the most important thing a urologist has to say about kidney infection.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Most kidney infections settle with antibiotics. <strong>An infected kidney that is also obstructed \u2014 by a stone, a narrowing or a tumour \u2014 does not.<\/strong> Antibiotics travel in the bloodstream and cannot sterilise infected urine trapped behind a blockage; the pressure keeps rising, bacteria enter the bloodstream, and a patient can deteriorate from unwell to critically ill within hours.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>That situation is a surgical emergency, and the treatment is drainage<\/strong> \u2014 a stent passed up to the kidney, or a tube through the skin \u2014 done urgently, with the stone or the underlying cause dealt with later once the infection has settled. It is not something antibiotics can be given time to work on.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Which is why the practical rule is: <strong>fever with flank pain in someone known to have stones, or who is not improving on antibiotics, needs a scan rather than a stronger prescription.<\/strong> See also <a href=\"https:\/\/drsoaraweeurology.com\/2023\/02\/26\/ureteral-stricture-causing\/\">narrowing of the ureter<\/a>, which produces the same problem without a stone.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"600\" data-attachment-id=\"2826\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ko\/2021\/04\/02\/acute-pyelonephritis\/micro-bacterium-and-therapeutic-bacteria-organisms-microscopic-salmonella-lactobacillus-or-acidophilus-organism-vector-background\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/E-coli.jpg?fit=1200%2C900&amp;ssl=1\" data-orig-size=\"1200,900\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Micro bacterium and therapeutic bacteria organisms. Microscopic salmonella, lactobacillus or acidophilus organism. Abstract biological vector background&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;Micro bacterium and therapeutic bacteria organisms. Microscopic salmonella, lactobacillus or acidophilus organism vector background&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"E coli is the most common cause in Acute bacterial pyelonephritis\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;E coli is the most common cause in Acute bacterial pyelonephritis&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/E-coli.jpg?fit=800%2C600&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/E-coli.jpg?resize=800%2C600&#038;ssl=1\" alt=\"Escherichia coli, the organism responsible for most kidney infections\" class=\"wp-image-2826\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/E-coli.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/E-coli.jpg?resize=300%2C225&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/E-coli.jpg?resize=1024%2C768&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/E-coli.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/E-coli.jpg?resize=16%2C12&amp;ssl=1 16w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/E-coli.jpg?resize=800%2C600&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/E-coli.jpg?resize=400%2C300&amp;ssl=1 400w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/E-coli.jpg?resize=200%2C150&amp;ssl=1 200w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Most kidney infections are caused by bowel bacteria that have climbed the urinary tract.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">How it happens<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Escherichia coli<\/em>, a normal inhabitant of the bowel, is responsible for most cases. It reaches the kidney in one of two ways:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Climbing up from the bladder<\/strong> \u2014 by far the commoner route. The bacteria carry fine hair-like projections that let them grip the lining and work upwards from the urethra through the bladder and ureter.<\/li>\n\n\n\n<li><strong>Through the bloodstream<\/strong> \u2014 uncommon, and mainly in people whose immunity is impaired.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">It is several times commoner in women, whose urethra is short, with young sexually active women, infants, older people and pregnant women most affected.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Two groups where it is never just a kidney infection<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Men.<\/strong> Pyelonephritis is uncommon in men, and when it happens it is a reason to look for why \u2014 a stone, obstruction from the prostate, an abnormality of the urinary tract. Treating the infection and stopping there misses the point.<\/li>\n\n\n\n<li><strong>Pregnancy.<\/strong> Kidney infection in pregnancy is a serious event that usually needs admission, threatens the pregnancy, and is exactly what screening for <a href=\"https:\/\/drsoaraweeurology.com\/2022\/07\/22\/asymptomatic-bacteriuria\/\">bacteria in the urine without symptoms<\/a> at the first antenatal visit is designed to prevent.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Symptoms<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Fever<\/strong>, often high and coming on suddenly, frequently with shaking chills.<\/li>\n\n\n\n<li><strong>Flank pain<\/strong>, usually on one side, over the kidney rather than low in the abdomen.<\/li>\n\n\n\n<li><strong>Nausea and vomiting.<\/strong><\/li>\n\n\n\n<li>Often, though not always, burning and frequency alongside \u2014 and sometimes blood in the urine.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">It develops fast, typically over hours. In older people the picture can be quieter and more confusing \u2014 <strong>confusion, unsteadiness or simply being unwell, sometimes without much fever<\/strong> \u2014 which is one reason kidney infection is missed in that group. Tapping over the kidney reproduces the pain, which is a useful bedside sign.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"2828\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ko\/2021\/04\/02\/acute-pyelonephritis\/woman-in-a-medical-mask-with-a-high-fever-holding-a-thermometer-in-his-hands-with-a-reading-of-39-5-severe-condition-of-a-coronavirus-patient-distribution-of-covid-19-in-the-incubation-period\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/High-grade-fever.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;5&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark II&quot;,&quot;caption&quot;:&quot;woman in a medical mask with a high fever. Holding a thermometer in his hands with a reading of 39.5. Severe condition of a coronavirus patient. Distribution of covid-19 in the incubation period.&quot;,&quot;created_timestamp&quot;:&quot;1584850307&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;55&quot;,&quot;iso&quot;:&quot;100&quot;,&quot;shutter_speed&quot;:&quot;0.01&quot;,&quot;title&quot;:&quot;woman in a medical mask with a high fever. Holding a thermometer in his hands with a reading of 39.5. Severe condition of a coronavirus patient. Distribution of covid-19 in the incubation period&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Febrile fever is 1 out of 3 classical signs.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Febrile fever is 1 out of 3 classical signs.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/High-grade-fever.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/High-grade-fever.jpg?resize=800%2C533&#038;ssl=1\" alt=\"High fever with shaking chills, characteristic of acute kidney infection\" class=\"wp-image-2828\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/High-grade-fever.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/High-grade-fever.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/High-grade-fever.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/High-grade-fever.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/High-grade-fever.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Fever with one-sided flank pain is the combination to act on.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Tests and treatment<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Urine testing shows inflammatory cells and bacteria, and <strong>a urine culture is taken before antibiotics are started<\/strong> \u2014 this is not a formality. It takes around two days and it is what allows a broad antibiotic to be narrowed to the right one, and what identifies a resistant organism if the first choice fails. Blood tests and blood cultures are added where the illness is more severe.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version described imaging as optional and reserved for severe cases. That is broadly right and worth stating more precisely, because it is how obstruction gets found. <strong>A scan is indicated where there are known stones, where the patient is a man, where there is diabetes or a single kidney, where the illness is severe \u2014 and, most importantly, where fever has not settled after about two to three days of appropriate antibiotics.<\/strong> A patient who is not improving is assumed to have something that needs draining until a scan says otherwise.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Antibiotics are started immediately after the culture is taken, by mouth for milder illness at home, intravenously in hospital for anyone vomiting, unstable, pregnant, or not improving. <strong>Finish the full course<\/strong> even once you feel well within a couple of days, and <strong>do not treat this with antibiotics bought over the counter<\/strong> \u2014 a partial course quietens the symptoms while leaving infection in the kidney and selecting for resistance.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What can go wrong<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">With prompt treatment the outlook is good. Delay, or an unrecognised blockage, allows <strong>an abscess in or around the kidney<\/strong>, <strong>bacteria in the bloodstream with septic shock<\/strong>, permanent scarring of the kidney, and \u2014 in people with diabetes especially \u2014 a rare gas-forming infection that destroys the kidney and is life-threatening. Diabetes is the single risk factor that turns a manageable infection into a dangerous one, which is why it lowers the threshold for admission and for scanning.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"599\" data-attachment-id=\"2825\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ko\/2021\/04\/02\/acute-pyelonephritis\/breakfast-cute-girl-at-the-table\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Drink-water.jpg?fit=1200%2C899&amp;ssl=1\" data-orig-size=\"1200,899\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;4.5&quot;,&quot;credit&quot;:&quot;Yeko Photo Studio&quot;,&quot;camera&quot;:&quot;Canon EOS 6D&quot;,&quot;caption&quot;:&quot;Morning. Attractive woman with glass of water&quot;,&quot;created_timestamp&quot;:&quot;1396370000&quot;,&quot;copyright&quot;:&quot;Yeko Photo Studio&quot;,&quot;focal_length&quot;:&quot;100&quot;,&quot;iso&quot;:&quot;500&quot;,&quot;shutter_speed&quot;:&quot;0.008&quot;,&quot;title&quot;:&quot;Breakfast. Cute girl at the table&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Drink plenty of water more than 2 Liters a day run as protective factor.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Drink plenty of water more than 2 Liters a day run as protective factor.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Drink-water.jpg?fit=800%2C599&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Drink-water.jpg?resize=800%2C599&#038;ssl=1\" alt=\"Drinking water, a preventive measure against recurrent urinary tract infection\" class=\"wp-image-2825\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Drink-water.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Drink-water.jpg?resize=300%2C225&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Drink-water.jpg?resize=1024%2C767&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Drink-water.jpg?resize=768%2C575&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Drink-water.jpg?resize=16%2C12&amp;ssl=1 16w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Drink-water.jpg?resize=800%2C600&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Drink-water.jpg?resize=400%2C300&amp;ssl=1 400w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/03\/Drink-water.jpg?resize=200%2C150&amp;ssl=1 200w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Fluid intake is a preventive measure between episodes \u2014 not a treatment during one.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Preventing it happening again<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Drink enough that urine stays pale<\/strong>, in the region of two litres a day for most people. This is a measure for between episodes; it does not treat an infection that is already established.<\/li>\n\n\n\n<li><strong>Do not hold urine<\/strong> when you feel the urge.<\/li>\n\n\n\n<li><strong>Wipe front to back<\/strong>, and <strong>pass urine after sex<\/strong>.<\/li>\n\n\n\n<li><strong>Get recurrent infections properly investigated<\/strong> rather than treated repeatedly. Repeated kidney infections, and any in a man, warrant looking for a cause \u2014 see <a href=\"https:\/\/drsoaraweeurology.com\/2020\/08\/14\/recurrent-bladder-infection\/\">why bladder infections keep coming back<\/a> and <a href=\"https:\/\/drsoaraweeurology.com\/2026\/07\/22\/prevent-recurrent-bladder-infections-uti-without-antibiotics\/\">how to prevent them without antibiotics<\/a>.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Kidney Infection<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">What are the symptoms?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Fever, often high and sudden with shaking chills; one-sided flank pain over the kidney; and nausea or vomiting. Burning and frequency are often present too. It develops over hours. In older people it can present as confusion or simply being unwell without much fever.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Why would antibiotics not be enough?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Because antibiotics cannot sterilise infected urine trapped behind a blockage. An infected kidney that is also obstructed by a stone or a narrowing is a surgical emergency needing urgent drainage, and a patient can deteriorate within hours. This is why failure to improve within two to three days prompts a scan rather than a stronger prescription.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Can I treat it at home?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Milder cases are treated at home with tablets after assessment and a urine culture. What is not safe is self-treating with leftover or over-the-counter antibiotics, which quietens symptoms while leaving infection in the kidney. Vomiting, instability, pregnancy, diabetes, a single kidney, known stones or failure to improve all point to hospital.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">I am a man and I have had a kidney infection. Does that matter?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Yes. It is uncommon in men, so it is treated as a reason to look for an underlying cause \u2014 a stone, obstruction from the prostate, or an abnormality of the urinary tract. Treating the infection alone leaves the reason it happened unaddressed.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How do I stop it coming back?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Keep fluid intake up so urine stays pale, do not hold urine, wipe front to back, pass urine after sex \u2014 and have recurrent episodes investigated rather than repeatedly treated, since repetition usually means something is being missed.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Arranging a consultation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>An acute episode goes to hospital, not to an appointment.<\/strong> Afterwards, or for recurrent infections, Dr. Soarawee Weerasopone sees patients at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Bangkok Hospital Headquarters<\/a> and at Samitivej Sriracha Hospital in Chonburi on <a href=\"tel:0880221445\">088-022-1445<\/a>. Bring previous urine culture results and details of any antibiotics already taken \u2014 those two things shorten the process considerably.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for non-urgent consultations, including for international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/04\/02\/acute-pyelonephritis\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2021\/04\/02\/acute-pyelonephritis\/\",\n      \"name\": \"Kidney Infection (Acute Pyelonephritis): When Antibiotics Are Not Enough\",\n      \"description\": \"Acute pyelonephritis presents with fever, flank pain and vomiting. 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Self-treatment with leftover or over-the-counter antibiotics is unsafe, quietening symptoms while leaving infection in the kidney. Vomiting, instability, pregnancy, diabetes, a solitary kidney, known stones or failure to improve indicate hospital care.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Does a kidney infection in a man need further investigation?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Yes. Pyelonephritis is uncommon in men and warrants a search for an underlying cause such as a stone, prostatic obstruction or a urinary tract abnormality.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>Fever with flank pain needs seeing the same day. Most kidney infections settle with antibiotics \u2014 but an infected kidney that is also blocked will not, and that distinction is the one that decides survival.<\/p>","protected":false},"author":185281453,"featured_media":10014,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Fever, flank pain and nausea mean a kidney infection until proved otherwise. 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