{"id":23,"date":"2007-11-28T10:19:30","date_gmt":"2007-11-28T09:19:30","guid":{"rendered":"https:\/\/blogs.bmj.com\/adc-archimedes\/2007\/11\/28\/question-how-to-diagnose-and-treat-pyelonephritis\/"},"modified":"2007-11-28T10:19:30","modified_gmt":"2007-11-28T09:19:30","slug":"question-how-to-diagnose-and-treat-pyelonephritis","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/adc\/2007\/11\/28\/question-how-to-diagnose-and-treat-pyelonephritis\/","title":{"rendered":"Question: How to diagnose and treat pyelonephritis"},"content":{"rendered":"<p><strong><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/bob_phillips.allmail.net\/renalUSS.jpg\" alt=\"Renal USS - spot the bad one\" align=\"left\" height=\"75\" hspace=\"6\" width=\"100\" \/>In children suspected of having a UTI, what clinical and radiological features diagnoses pylonephritis, and what mode of antibiotic treatment is necessary to produce clinical improvement and avoid chronic renal impairment?<\/strong><\/p>\n<p>With the publication of the NICE guidance in the UK on the management of UTI in childhood, many paediatricians have been spurred to review their understanding of the evidence underpinning certain aspects of the clinical pathway.<!--more-->Questions about pyelonephritis are being asked in the City Hospital, Birmingham, UK &#8211; how should it be diagnosed, and treated with what sorts of antibiotics, given by which route, and for how long? The questions are certainly open for debate &#8212; as is this blog entry.<\/p>\n<p>Can we reliably differentiate between a bladder and a kidney infection in children? Does the diagnosis make any difference anyway? Do you really need 48h of IV antibiotics <em>just<\/em> because you&#8217;re &lt;12m old with white cells in your urine?<\/p>\n<p>Acnowledgements:<\/p>\n<p>Image:  mariaboismain from <a href=\"http:\/\/flickr.com\/photos\/mariaboismain\/445904449\/\" title=\"Original Source\">Flickr <\/a>under the <a href=\"http:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en_GB\" title=\"Licence details\">creativecommons2.0 licence<\/a>.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In children suspected of having a UTI, what clinical and radiological features diagnoses pylonephritis, and what mode of antibiotic treatment is necessary to produce clinical improvement and avoid chronic renal impairment? With the publication of the NICE guidance in the UK on the management of UTI in childhood, many paediatricians have been spurred to review [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/adc\/2007\/11\/28\/question-how-to-diagnose-and-treat-pyelonephritis\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[81,103,159,82,160],"tags":[],"class_list":["post-23","post","type-post","status-publish","format-standard","hentry","category-diagnostics","category-nephrology","category-radiology","category-therapy","category-uti"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Question: How to diagnose and treat pyelonephritis - ADC Online Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/adc\/2007\/11\/28\/question-how-to-diagnose-and-treat-pyelonephritis\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Question: How to diagnose and treat pyelonephritis - ADC Online Blog\" \/>\n<meta property=\"og:description\" content=\"In children suspected of having a UTI, what clinical and radiological features diagnoses pylonephritis, and what mode of antibiotic treatment is necessary to produce clinical improvement and avoid chronic renal impairment? With the publication of the NICE guidance in the UK on the management of UTI in childhood, many paediatricians have been spurred to review [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/adc\/2007\/11\/28\/question-how-to-diagnose-and-treat-pyelonephritis\/\" \/>\n<meta property=\"og:site_name\" content=\"ADC Online Blog\" \/>\n<meta property=\"article:published_time\" content=\"2007-11-28T09:19:30+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/bob_phillips.allmail.net\/renalUSS.jpg\" \/>\n<meta name=\"author\" content=\"Bob Phillips\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Bob Phillips\" \/>\n\t<meta name=\"twitter:label2\" content=\"Estimated reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2007\\\/11\\\/28\\\/question-how-to-diagnose-and-treat-pyelonephritis\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2007\\\/11\\\/28\\\/question-how-to-diagnose-and-treat-pyelonephritis\\\/\"},\"author\":{\"name\":\"Bob Phillips\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#\\\/schema\\\/person\\\/9e94029681ecf36e73bbd1eb2be2ef94\"},\"headline\":\"Question: How to diagnose and treat pyelonephritis\",\"datePublished\":\"2007-11-28T09:19:30+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2007\\\/11\\\/28\\\/question-how-to-diagnose-and-treat-pyelonephritis\\\/\"},\"wordCount\":170,\"commentCount\":3,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#organization\"},\"articleSection\":[\"diagnostics\",\"nephrology\",\"radiology\",\"therapy\",\"UTI\"],\"inLanguage\":\"en-GB\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2007\\\/11\\\/28\\\/question-how-to-diagnose-and-treat-pyelonephritis\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2007\\\/11\\\/28\\\/question-how-to-diagnose-and-treat-pyelonephritis\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2007\\\/11\\\/28\\\/question-how-to-diagnose-and-treat-pyelonephritis\\\/\",\"name\":\"Question: How to diagnose and treat pyelonephritis - 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