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“The future belongs to those who believe in the beauty of their dreams.”

Eleanor Roosevelt, (1884-1962), American political figure, diplomat, and activist.

Pyelonephritis

Kidney infection is frequent in women of all age.

GPs and specialists in internal medicine are not trained correctly to diagnose and treat this entity.

Hence, in my hospital practice I could witness on several occasions severe sepsis, even endangering patient’s life or simply kidney loss.

Already 60 years ago pathologists specialized in the domain were trying to show methods of diagnosis.

Only ones present at that time were leukocyturia, hematuria, and low urine density, or high PH on urine sediment.

On clinical examination diagnosis is easy and simple for the experienced practitioner.

Pain or severe ache in renal lodge on shaking it is sufficient for orientation.

An antibiogram is mandatory, as you have to deal frequently with resistant germs from the intestinal flora.

Here doctors trained in internal medicine feel misled by the result.

Cystitis goes together with 10⁷ or 10⁶ germs at least.

Most physicians possess still insufficient knowledge in basic science, like mathematics, physics and geometry.

Hence, the difficulty!

Mucosa of the bladder covers a huge lining, while kidney infection concerns only a pyramid at beginning, and thus goes with 10⁵, 10⁴, or even less germs.

Already half a century ago it had been published that pyelonephritis needs combined therapy with parenteral aminoglycoside and penicillin.

Nowadays, precise diagnosis is easy, fast and inexpensive.

Ultrasound shows a hyperechogenic pyramid in kidney cortex.

Rarely, it is hypoechogenic when it nears abscess formation.