Pyelonephritis physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
PMID: perinephric abscess 17219288, 18787367, 30454580, 3806801, 17324312
Physical Examination
The following features can be found during a physical examination of a patient with pyelonephritis. The patient must be in supine position to facilitate a proper examination.[1][2]
General Appearance of the Patient
- Patients with Pyelonephritis are usually in distress.
- Patient may have hands on abdomen or back at the area of tenderness
Vital Signs
The following variations in Vital Signs can be seen in Pyelonephritis. [3]
- Fever may be present
- High Blood pressure-early finding of kidney involvement
- Hypotension may also be seen if patient is in shock
Abdomen
- Tenderness of the bladder area
- Costo-vertebral angle tenderness("renal angle tenderness")
Digital rectal examination (DRE)
A DRE is a physical exam of the prostate that is performed in the health care provider’s office. Anesthesia is not needed. To perform the exam, the health care provider asks the person to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies in front of the rectum.
- Men with suspected pyelonephritis may have a DRE to determine whether a swollen prostate may be obstructing the neck of the bladder.
Genitourinary
The following findings may be found on genitourinary examination of a patient with Pyelonephritis.[2][4][5].
- Renal angle tenderness
- Suprapubic tenderness
- Urethral discharge(if the cause is urethritis)
- Inguinal Lymphadenopathy
- Examination of the scrotum and the pubic area must be done
Cardiovascular
Neurological
References
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.
- ↑ 2.0 2.1 Colgan R, Williams M (2011). "Diagnosis and treatment of acute uncomplicated cystitis". Am Fam Physician. 84 (7): 771–6. PMID 22010614.
- ↑ Chang SL, Shortliffe LD (2006). "Pediatric urinary tract infections". Pediatr Clin North Am. 53 (3): 379–400, vi. doi:10.1016/j.pcl.2006.02.011. PMID 16716786.
- ↑ Brill JR (2010). "Diagnosis and treatment of urethritis in men". Am Fam Physician. 81 (7): 873–8. PMID 20353145.
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.