Differential Diagnosis for Acute Pyelonephritis
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI) with ascent to the kidneys: This is the most direct and common cause of acute pyelonephritis, often resulting from bacterial infection such as E. coli.
Other Likely Diagnoses
- Kidney stones with infection: The presence of kidney stones can obstruct the flow of urine, leading to an increased risk of infection.
- Prostatitis: In men, prostatitis can lead to urinary retention and increase the risk of developing acute pyelonephritis.
- Cystitis with upper tract involvement: Cystitis that moves up the urinary tract can cause pyelonephritis.
Do Not Miss Diagnoses
- Sepsis: A severe infection that can lead to life-threatening complications if not promptly treated. Pyelonephritis can be a source of sepsis.
- Pyclonephritis in pregnancy: Pregnancy increases the risk of pyelonephritis due to physiological changes, and if not treated, it can lead to serious complications for both mother and fetus.
- Emphysematous pyelonephritis: A severe, necrotizing infection of the kidney, more common in diabetic patients, which requires prompt diagnosis and treatment.
Rare Diagnoses
- Xanthogranulomatous pyelonephritis: A rare form of chronic pyelonephritis characterized by the destruction of renal tissue and the presence of granulomatous tissue.
- Malakoplakia: A rare inflammatory condition that can affect the urinary tract, including the kidneys, and is associated with chronic infection.
- Tuberculosis of the kidney: Although rare in some parts of the world, renal tuberculosis can mimic pyelonephritis and requires specific treatment.