Kidney Infection (cont.)
What are the signs and symptoms of kidney infection?
Some of the common symptoms of kidney infection include:
Signs of kidney infection on exam may include:
- fever,
- tenderness on the flanks (costo-vertebral angle tenderness, referring to tenderness upon
tapping gently on the mid back on the sides), and
- clinical evidence of infection
in the urinalysis (analysis of urine).
In elderly patients and those with weak immune systems, kidney infection may
be more severe with confusion, rapid heart rate,
low blood
pressure, and dehydration.
How is kidney infection diagnosed?
Kidney infection may be diagnosed by a physician by performing a complete
physical examination and taking a detailed medical history. The evaluation
includes checking the vital signs (heart
rate, blood pressure, temperature, and
respiratory rate), assessing for signs of dehydration, and checking for
tenderness on the mid and lower back. In young, female patients a pelvic exam may also
be necessary to evaluate for pelvic infection (pelvic inflammatory disease or
PID). Pregnancy test may also be performed.
Urinalysis test is essential for the diagnosis of kidney infection. The urine
sample must be properly collected. The urethra needs to be wiped clean properly
before the sample is collected in order to avoid contamination of urine by the
bacteria on the skin around the urethra. The initial stream of urine may also be
voided in the toilet before the collecting urine in the provided container. This
is called the mid-stream, clean-catch urine. After an appropriate amount of
urine is collected (about 10 milliliters or cc's) in the container, the remaining
urine may also be voided in toilet.
A urinalysis suggestive of an infection in the urine (presence of white blood
cells or bacteria in the urine) in general, is highly suggestive and supportive of the
diagnosis of kidney infection or urinary tract infection. A urine
sample without evidence of urine infection makes kidney infection unlikely and
another diagnosis may be considered.
Once white blood cells and other indications of urine
infection [such as, leukocyte esterase (produced by white blood cells in urine) or nitrites
(produced by bacteria in urine)] are noted on the urinalysis,
it is important to determine the amount and the type of bacteria in the urine
sample. Generally, a urine sample that has greater than 100,000 bacteria in one
cc of urine is considered diagnostic of urinary tract infection. In some
clinical settings, counts of less than 100,000 bacteria in one cc of urine may
also indicate an
infection.
Next: What are different types of kidney infection? »
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