စူးရှသော Pyelonephritis - ကျောက်ကပ်၏ဘက်တီးရီးယားပိုးကူးစက်မှု

နောက်ဆုံး ပြင်ဆင်သည် ဧပြီ 23, 2026

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Acute Pyelonephritis is a bacterial infection of the kidney and falls under the responsibility of urologists. It is predominantly caused by the gram-negative bacterium Escherichia coli (E. coli), which normally lives as normal flora in human feces but is highly harmful when it enters the urinary tract.

• ထိုင်းနိုင်ငံ ဆီးလမ်းကြောင်းဌာန ဘန်ကောက်ဆေးရုံ အွန်လိုင်းဘွတ်ကင်လုပ်ခြင်း။ 02-310-3009 bhquro@bdms.co.th
• Samitivej Sriracha ဆေးရုံ Chonburi 088-022-1445

Routes of bacterial penetration to the kidney

1. Ascending infection from the lower urinary tract — the most common route. E. coli uses fimbriae (leg-like appendages) to climb from the urethra upward through the bladder, ureter, and into the kidney, causing acute pyelonephritis
2. Hematogenous ပျံ့နှံ့ခြင်း။ — a rare cause, typically occurring in immunocompromised patients when bacteria enter the bloodstream and seed the kidney

Acute pyelonephritis is 5 times more common in females than males. Young sexually active women are the most commonly affected group, followed by infants, the elderly, and pregnant women.

Classical triad of symptoms

• ဖျားခြင်း။ ကိုယ်ပူခြင်း — often high-grade and sudden onset
• ခါးနာခြင်း။ — typically unilateral, over the affected kidney area
• Nausea or vomiting

Symptoms typically develop within hours. Painful urination and blood in urine may also be present, particularly in female patients. Physical examination often reveals tenderness on flank percussion (costovertebral angle tenderness). Urinalysis is the most useful initial investigation, frequently showing large numbers of white blood cells (pyuria). Imaging (CT scan) is optional and reserved for clinically severe or complicated cases.

Acute pyelonephritis can be managed as outpatient or inpatient depending on severity. Once diagnosed, a urine culture must be collected to identify the specific pathogen (results take approximately 48 hours). During this waiting period, broad-spectrum antibiotics are started empirically. When culture results confirm the pathogen and its sensitivity, treatment is adjusted to a targeted narrow-spectrum antibiotic.

Prognosis is excellent with timely treatment. Delayed treatment can lead to serious complications including renal abscess, emphysematous pyelonephritis (gas-forming infection), urosepsis, or kidney failure.

Prevention of Acute Pyelonephritis

1. Drink more than 2 litres of water per day to flush bacteria from the urinary tract
2. Do not hold urine — urinate when the urge occurs
3. Wipe from front to back after urination and defecation (especially important for women)
4. Urinate after sexual intercourse to flush any ascending bacteria

Frequently Asked Questions About Acute Pyelonephritis

What are the symptoms of acute pyelonephritis?

The classical triad of acute pyelonephritis is fever (often high-grade), flank pain (over the affected kidney), and nausea or vomiting. These symptoms typically develop rapidly within hours. Females may also experience painful urination and blood in the urine simultaneously. Physical examination typically shows tenderness when the flank is tapped (CVA tenderness). Any patient with fever combined with flank pain should seek medical evaluation urgently, as untreated pyelonephritis can progress to sepsis or renal abscess.

How is acute pyelonephritis diagnosed and treated?

Diagnosis is based on clinical symptoms (fever, flank pain, nausea), urinalysis (showing pyuria and bacteriuria), and urine culture (to identify the specific organism and its antibiotic sensitivity). CT scan is reserved for complicated or severe cases. Treatment begins immediately with broad-spectrum antibiotics while awaiting culture results. Once the urine culture confirms the pathogen (approximately 48 hours), antibiotics are adjusted to a targeted narrow-spectrum agent. Mild cases may be managed as outpatients; severe cases with high fever, vomiting, or signs of sepsis require inpatient IV antibiotics.

How can I prevent pyelonephritis from recurring?

Prevention focuses on reducing ascending bacterial migration through the urinary tract. Key measures include: drinking more than 2 litres of water daily (to flush bacteria), not holding urine, wiping front to back after using the toilet (critical for women to prevent fecal bacteria from reaching the urethra), and urinating after sexual intercourse. Women who experience recurrent urinary tract infections should consult a urologist for evaluation of any anatomical or functional factors predisposing to recurrence, and to discuss prophylactic antibiotic strategies if appropriate.

If you suspect acute pyelonephritis or have recurrent kidney infections, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. ပြ ခ ဂ ဃ င.

ရှောင်ကြဉ်ချက်: ဤအကြောင်းအရာကို ဘန်ကောက်ဆေးရုံဌာနချုပ်ရှိ ဘုတ်လက်မှတ်ရရှိထားသော ဆီးလမ်းကြောင်းနှင့် ဆီးအိမ်အထူးကု ဆရာဝန် ဒေါက်တာ ဆိုရာဝီ ဝီရာဆိုပွန်က ရေးသားပြီး ပြန်လည်သုံးသပ်ထားပါသည်။ ဤအကြောင်းအရာသည် ပညာရေးဆိုင်ရာ ရည်ရွယ်ချက်အတွက်သာ ရည်ရွယ်ထားပြီး ဆေးဘက်ဆိုင်ရာ အကြံဉာဏ် မဟုတ်ပါ။ မည်သည့် ဆေးကုသမှုကိုမဆို စတင်မပြုမီ အရည်အချင်းပြည့်မီသော ကျန်းမာရေးပညာရှင်တစ်ဦးနှင့် အမြဲတမ်း ဆွေးနွေးတိုင်ပင်ပါ။.