Acute pyelonepritits

Ascending
Haemotogneous
immunosuppressan
t

APN
Cost
phrenic
angle
acute

fever

Acute pancreatitis

Leucocyte
esterase
Nitrate
White cell cast
To detect pyuria
10 000 colony
forming units
per
units+sympto
ms

Urinalysis

Acute
pyelonephritis

Urine culture

Acute cholecytitis

Routine imaging
not recommend
unless symptoms
presisitestend

mild

moderate

severe

Outpatient
Oral
antibiotics(fluoroq
uinolone)

Inpatient
IV antibiotics

Improve oral

No acces
No transport

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Age
Infant
Youngpregnancy,sexual
and contraception
Oldprostatitis,protate
hyperthrophy
Poor response>32
Recurrent infection
Diagnostic uncertain
High calculi
obstruction\
Abscess
Congenital anomalies
Chronic renal scraning
Impare renal fx

Neprolithiasis
ressitant

Fever

>38
Immunocompri
sed
Early symtoms

Flank
pain

nause
a

sympto
ms

LUTs

vomit
ng

Oral
IV

Pregnant
Parenteral 2 and 3
cephalo

Oral amoxicillin
Clavulanate
Cephalosporin
Cotrimoxazole(trimetho
primsulfamethoxqazole)

E-coli

enterobacteriac
eae

p.aueuginosa

Enterococcig

Group b
strep

Anaerob
ic
negativ
e
bacteria