#EMConf: Pyelonephritis Management Pearls
Thu, 03/07/2019 - 7:00am
- Healthy + young females + tolerating PO + well appearing
- Admit anyone else
- Pregnancy gets admitted for increased risk for preterm labor.
Should you send blood culture if admit?
- about 30% of patients will have positive blood culture but 97% will grow the same bug in urine as in blood therefore urine culture is adequate
- send blood culture if patient is septic or concerned for renal abscess
When should you think about renal abscess?
- failing outpatient or inpatient therapy for pyelonephritis
- consider this for diabetics who are at highest risk for this and for emphysematous pyelonephritis (necrotizing infection of kidney that is rapidly progressive with a 20% mortality)