KIDNEY INFECTIONS MAY SEEM MILD, BUT CAN BE SERIOUS

Question: I went to the emergency department recently with back pain, and they said I had a kidney infection. I really didn’t have many other symptoms except generally feeling run-down. They gave me some antibiotics, and my pain got better, so they must have been right. How did I get this? Why didn’t I have any other noticeable symptoms?

Answer: Pyelonephritis is the medical term for an infection in the kidneys or the ureters, which are the tubes that lead from the kidneys to the bladder. Pyelonephritis is usually caused when bacteria moves up the ureters from the bladder, in what we call an “ascending infection.”

Pyelonephritis can be caused by a number of things, including bladder infections, bladder catheterization, urinary tract surgeries, kidney stones, prostate enlargement or structural problems in the urinary system that block urine flow from the kidneys to the bladder.

The most common symptom of pyelonephritis is back pain. Pain caused by kidney infection is usually felt just below the rib cage and close to the spine. Typically the pain is described as a dull ache, much less intense than the acute pain associated with kidney stones. Kidney infection pain also tends to come and go, and it may extend to the side of the body or down into the pelvic area.

As you noted, sometimes the symptoms are limited to back pain alone. If you experience new and sudden back pain, it is a good idea to see a doctor about it. Many people also have associated symptoms of painful urination, frequent urination, blood in the urine, fever and nausea or vomiting. If you notice these symptoms, see your doctor immediately.

In some cases, people become extremely ill with pyelonephritis and have to be hospitalized. This can occur when the kidney infection spreads to the blood stream. This is called septicemia, and it often begins with rapid breathing, increased heart rate, chills and a sharp spike in fever. Severe pyelonephritis can also cause the kidneys to stop functioning, which is a potentially fatal situation with a number of symptoms, from bloody stools and breath odor to tremors and swelling of the lower body.

When you went to the emergency department, the doctor probably began by tapping on the kidney area to see if it caused you pain. Then, most likely, your blood was drawn to be checked for a high white blood cell count, which would indicate infection. They probably also obtained a urine specimen to examine for bacteria. Once bacteria are cultured and identified, the doctor can prescribe the most effective antibiotic.
Most people respond quickly to antibiotic treatment, and their symptoms resolve without further complication. A thorough follow-up usually calls for x-rays of the entire urinary tract to look for structural problems in the system that may have caused the problem.