Kidney infection (pyelonephritis)

For a lay person:

Pyelonephritis is a bacterial infection of one or both kidneys, usually spreading up from a bladder infection. It is more common in women, in pregnancy and in people with kidney stones or a blocked urinary tract, and causes fever, back or side pain and feeling unwell.

For a trained medical person:

An upper urinary tract infection most often caused by ascending Escherichia coli and other enteric Gram-negative bacteria; obstruction, reflux, pregnancy, diabetes and catheters are risk factors. Diagnosis rests on symptoms, flank tenderness, urinalysis and urine culture, with blood cultures and imaging in severe, recurrent or complicated cases. Treatment is prompt antibiotics guided by culture, with hospital admission for sepsis, vomiting, pregnancy or obstruction.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Lower Jiao Damp-Heat; Liver and Gallbladder Damp-Heat; Damp-Heat Damaging Collaterals; Yin Deficiency with Damp-Heat; Spleen and Kidney Yang Deficiency. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Seek medical care the same day for fever with back or side pain, and urgent care for vomiting, confusion, rapid breathing or pregnancy; a kidney infection needs antibiotics and Chinese medicine is adjunctive at most.