Acute pyelonephritis

• Acute bacterial infection of the kidney produces loin pain and constitutional upset, with fever, rigor, nausea and sometimes vomiting.

• The symptoms of acute cystitis are often also present.

• The differential diagnosis includes causes of the acute abdomen such as appendicitis, cholecystitis and acute tubal or ovarian diseases. The presence of pyuria and absence of rebound tenderness are helpful in distinction.

The clinical manifestations of UTI are summarised in Figure 22.1 . Uncomplicated urinary tract infection

This is cystitis occurring in the uninstrumented non-pregnant female without structural or neurological abnormalities.

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