Acute pyelonephritis

The symptoms of acute pyelonephritis generally develop rapidly over a period of a few hours or a day or two. The characteristics are aching pain in the lumbar region and fever which may be high, often with shaking chills. There may be nausea, vomiting, and diarrhea or, occasionally, constipation. Dysuria and frequency are also common.

On physical examination in addition to fever and some generalized tenderness of the muscles, the key finding is tenderness on deep pressure in one or both of the costovertebral areas or on bimanual palpation of the kidney region. Occasionally, this sign is absent.

Except in individuals with papillary necrosis or urinary obstruction, the manifestation of acute pyelonephritis usually subside within days, even without specific antibacterial therapy. The patient becomes symptom-free although laboratory tests may show that bacteriuria with or without pyuria is still present. When pyelonephritis is severe, fever subsides more slowly and may not disappear for several days, even after appropriate antibiotic treatment has been started.

Most persons recover completely and permanently after attack of acute pyelonephritis, but in a considerable proportion of cases there are repeated attacks, at irregular intervals, sometimes over a period of many years; between these attacks the patient may be symptom-free. Bacteriuria and pyuria are often demonstrable during these symptom-free intervals. Infection in any part of the urinary tract is capable of subclinical continuation for months or years, during which a patient may have no symptoms and may live an apparently normal life, even though urine cultures provide continuing evidence of active infection.

POST-TEXT ASSIGNMENTS:

Exercise 7. Answer the questions:

How long do the symptoms of acute pyelonephritis develop?

What are the characteristic symptoms of acute pyelonephritis?

What is the key finding on physical examination?

How long does the manifestation of acute pyeolnephritis last?

What may laboratory analyses show even when the patient is symptom-free?

Is the recovery after the attack of acute pyeolnephritis complete?

Exercise 8. Approve or contradict:

— the patient becomes symptom-free although laboratory tests may show that bacteriuria with pyuria is still present;

— the symptoms of acute pyelonephritis are: fever, vomiting and aching pain in the lumbar region;

— when pyelonephritis is severe, fever subsides more slowly and may not disappear for several days, even after appropriate antibiotic treatment has been started;

— bacteriuria and pyuria are absent in case of acute pyelonephritis;

— infection in any part of the urinary tract is capable of subclinical continuation for months or years.

Exercise 9. Finish the sentences using information from the text:

The symptoms of acute pyelonephritis generally develop ….

The key finding on physical examination is ….

Within days the patient becomes symptom-free although laboratory tests may show ….

The manifestation of acute pyelonephritis usually subside ….

Most persons recover … and ….

Infection in any part of the urinary tract is capable of ….

In a considerable proportions of cases there repeated attacks, sometimes over….

Exercise 10. Give English equivalents of the following word combinations:

Проявление острого пиелонефрита, поясничная область, закупорка мочевых путей, культура мочи, бессимптомное продолжение, специфическое антибактериальное лечение, дальнейшее доказательство, ноющая боль, при глубоком надавливании, несколько дней.

Exercise 11. Translate the sentences:

1.Признаки острого пиелонефрита развиваются быстро, в течение нескольких часов или нескольких дней.

2.Особенностями болезни являются ноющая боль в поясничной области и лихорадка, которая может быть высокой, часто с ознобом.

3. Может быть тошнота, рвота, диарея, иногда, запор.

4.Большинство людей выздоравливает полностью после приступа острого пиелонефрита.

5.Инфекция в любой части мочевых путей способна к бессимптомному продолжению в течение многих месяцев или лет.

6. В течение этого периода пациент может не иметь никаких признаков, и может жить нормальной жизнью.

7. Культуры мочи дает дальнейшие доказательства активной инфекции.

Exercise 12. Make questions to the underlined words:

The symptoms of acute pyelonephritis generally develop rapidly.

On physical examination the key finding is tenderness on deep pressure.

Most persons recover completely after attack of acute pyelonephritis.

Laboratory tests may show bacteriuria.

The characteristic features are pain in the lumbar region and fever.

The manifestations of acute pyelonephritis usually subside within days.

Fever subsides slowly.

Exercise 13. Explain in English what is:

pyelonephritis

pyuria

bacteriuria

urinary obstruction

Exercise 14. The following are terms referring to some types of diseases. Match the types with their definitions.

1. acute a. indicating hypersensitivity to particular foods, kinds of

pollen, insect stings, etc.

2. allergic b. caused by mental stress

3. chronic c. coming sharply to a crisis

4. congenital d. lasting for a long time

5. contagious e. due to disturbances in anabolic and catabolic processes

6. familial f. transmitted genetically from parent to child

7. infectious g. caused by improper diet

8. metabolic h. spread by bacteria or viruses

9. nutritional i. present from of before birth

10. psychosomatic j. spreading by physical contact

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