What are the differential diagnoses for pyelonephritis (infection of the kidney) and their associated symptoms?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 11, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Pyelonephritis

The differential diagnosis for pyelonephritis includes various conditions that may present with similar symptoms. Here's a categorized list of potential diagnoses:

  • Single Most Likely Diagnosis
    • Urinary Tract Infection (UTI) with ascent to the kidneys: This is the most common cause of pyelonephritis, typically resulting from the ascent of bacteria from the lower urinary tract to the kidneys.
  • Other Likely Diagnoses
    • Kidney stones: Can cause obstructive uropathy, leading to pyelonephritis, especially if there is an associated infection.
    • Prostatitis: In men, prostatitis can cause symptoms similar to pyelonephritis, such as flank pain and urinary frequency.
    • Interstitial nephritis: A condition characterized by inflammation of the kidney tissue, which can be caused by medications, infections, or other factors.
  • Do Not Miss Diagnoses
    • Sepsis: A life-threatening condition that can result from untreated pyelonephritis, especially in patients with underlying medical conditions or compromised immune systems.
    • Emphysematous pyelonephritis: A rare but potentially deadly condition characterized by gas formation in the kidney tissue, often seen in patients with diabetes or immunocompromised states.
    • Papillary necrosis: A condition that can cause severe kidney damage and is often associated with analgesic abuse, diabetes, or sickle cell disease.
  • Rare Diagnoses
    • Xanthogranulomatous pyelonephritis: A rare form of chronic pyelonephritis characterized by the destruction of kidney tissue and the formation of granulomas.
    • Malakoplakia: A rare condition characterized by the formation of granulomas in the kidney tissue, often associated with chronic infection or inflammation.
    • Tuberculosis: A rare cause of pyelonephritis, especially in areas with high prevalence of tuberculosis.

Each of these diagnoses has distinct characteristics and risk factors, and a thorough evaluation is necessary to determine the underlying cause of symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.