Urinary Tract Infections and Acute Pyelonephritis Symptoms

Q: Urinary Tract Infections and Acute Pyelonephritis Symptoms

Hello： Urinary tract infections can potentially progress to nephritis, and it cannot be determined solely through tests; symptoms must also be considered (BUN and creatinine levels may be normal). <br>Here are some points for reference： 1) Based on personal experience, a typical

Urinary tract infection with fever?

My mother has the following symptoms: burning sensation during urination, decreased urine output, and fever.
After visiting the doctor and undergoing blood and urine tests, it was found that her white blood cell count was significantly elevated, and there were red and white blood cells in her urine.
The doctor diagnosed her with a urinary tract infection and prescribed medication for treatment.
According to medical knowledge, these symptoms suggest that the infection has progressed from the lower urinary tract to the upper urinary tract (acute pyelonephritis).
I would like to ask the doctor if it is possible for BUN and creatinine levels to be within normal ranges in cases of acute pyelonephritis, as my mother's blood test results showed normal values for liver function tests, BUN, and creatinine.
Thank you.

Feng, 30~39 year old female. Ask Date: 2021/06/05

Dr. Du Shixi reply Urology

Hello: Urinary tract infections can potentially progress to nephritis, and it cannot be determined solely through tests; symptoms must also be considered (BUN and creatinine levels may be normal).
Here are some points for reference: 1) Based on personal experience, a typical urinary tract infection shows significant improvement after 3 days of medication.
If there is no improvement or symptoms worsen after 1-2 days of completing the medication, it may indicate that oral treatment is insufficient to control the infection, and one should be more vigilant (pay attention to lifestyle).
2) This is especially true for patients with chronic illnesses who are on long-term medication.
3) Additionally, be aware of any other symptoms that may arise, such as diarrhea, abdominal pain, back pain, cough, wheezing, or dizziness, as it is possible to have two conditions simultaneously, which should not be overlooked.
PS: Your family member should increase fluid intake (low urine output is not good, but avoid excessive drinking that could lead to edema).
Monitor their mental state and appetite, and try to avoid spicy and irritating foods.
If there is no improvement or if symptoms change, it is safer to seek medical attention (of course, wishing for a complete recovery).
Furthermore, even after completing the medication, a follow-up visit is necessary to determine if the infection has fully resolved, to prevent incomplete treatment and a recurrence in a short time.
Wishing you good health.

Reply Date: 2021/06/05

More Info

Urinary tract infections (UTIs) are common conditions that can affect various parts of the urinary system, including the bladder (cystitis) and the kidneys (pyelonephritis). Your mother’s symptoms, including burning during urination, decreased urine output, and fever, are indicative of a UTI. The presence of elevated white blood cells and both red and white blood cells in her urine further supports this diagnosis.
Acute pyelonephritis, which is an infection of the kidneys, can develop from a lower urinary tract infection if it is not adequately treated. The symptoms of pyelonephritis can include fever, chills, flank pain, and nausea, in addition to the urinary symptoms your mother is experiencing. It is crucial to address these infections promptly to prevent complications, including kidney damage.

Regarding your question about blood urea nitrogen (BUN) and creatinine (CREA) levels being normal in the context of acute pyelonephritis: yes, it is possible for these values to remain within normal ranges even when a patient has an active kidney infection. BUN and creatinine are markers of kidney function, and while they can be elevated in cases of kidney damage or dysfunction, they may not always reflect the presence of an infection. In the early stages of acute pyelonephritis, especially if the kidneys are still functioning well, these values can remain normal.
It is essential to monitor your mother’s symptoms closely. If she continues to experience urinary symptoms or if her fever persists, she should follow up with her healthcare provider. Additionally, it is important to ensure she completes the full course of antibiotics prescribed, even if her symptoms improve, to prevent recurrence or complications.

In terms of management, increasing fluid intake can help flush out the urinary system, but it should be balanced to avoid excessive fluid intake that could lead to edema. Avoiding irritants such as caffeine, alcohol, and spicy foods can also be beneficial during recovery.
If your mother experiences any new symptoms, such as severe flank pain, persistent fever, or changes in her mental status, it is crucial to seek medical attention immediately, as these could indicate a more severe infection or complications.

In summary, while your mother’s normal BUN and creatinine levels do not rule out acute pyelonephritis, it is vital to continue monitoring her symptoms and ensure she receives appropriate treatment. Regular follow-ups with her healthcare provider will help ensure that her condition is managed effectively and that any potential complications are addressed promptly.

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