Pyelonephritis is the inflammation of the upper urinary tract caused by bacterial infection. Signs and symptoms include abdominal pain, fever, burning and frequent urination, and nausea. It is accompanied by complications like pus around the kidney, sepsis, and even kidney failure ( Nicolle, 2008) . In the case of Ms. Cornwall, Escherichia coli is the kind of bacteria causing the infection. This analysis aims at identifying why Cornwall has bacteria and white blood cell casts in her urine and comparing different renal injuries.
Pyelonephritis causes the presence of white blood cell casts and bacteria in urine. The onset of the symptom is usually sudden or acute, chills and high fever of up to 104 degrees Farads. The inability to empty the bladder, painful urination and fever, especially in older people are most common. The infection roots medullary infiltration of white blood cells with a renal enema, renal inflammation, and pus-filled urine. If the infection is severe, localized abscesses are formed in the medulla which extends to the cortex ( Kleeman et al., 1960) . The tubules of the kidney are most affected. After the acute stage, healing occurs with deposition of fibroids, scar tissue. The presence of bacteria and white blood cell casts in Ms. Cornwall’s urine was clearly due to the bacterial urinary tract infection (UTI).
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Acute Pyelonephritis results from the bacterial incursion of the renal parenchyma. These bacteria later reach the kidney by ascending from the lower parts of the urinary tract. This condition occurs as a problem of ascending urinary tract infection (UTI) that spreads from the bladder towards the kidneys. Episodes of bacteriuria commonly occur in all age groups, but most of them are asymptomatic, therefore, do not cause infection. Mostly, infection development is influenced by host and bacterial factors ( Roberts, 1991) . At times, bacteria may as well reach the kidney through the bloodstream. In this process, hematogenous sources of organisms like Staphylococcus that are gram-positive, are endocarditis and arterial drug abuse. For the case of Ms. Cornwall, the gram-positive bacteria is Escherichia coli.
Acute kidney injury is branded by abrupt deterioration in kidney function that is manifested by a rise in serum creatinine level with minimal urine output. The extent of injury ranges from mild to advance injury that might require renal replacement dialysis. Acute kidney injury is classified into prerenal, intrinsic, and postrenal acute renal injuries ( Mehta et al., 2007 ). Prerenal acute renal injury is caused by a reduction in renal perfusion, frequently due to capacity depletion, for example, systematic vasodilation. The causes of volume depletion are extrarenal loss caused by vomiting, blood loss, burns, diarrhea, and sweating. There is also renal loss caused by osmotic diuresis and diuretic overuse. Intrinsic acute renal injury, on the other hand, is caused by a process within the kidneys. An example is vascular involving renal vein thrombosis, renal infarction, malignant hypertension, and renal thrombotic disease. Postrenal acute renal injury, on the other hand, is caused by inadequate drainage of urine distal to the kidney. Postrenal include extrarenal obstruction and intrarenal obstruction caused by stones, tumors, crystals, and clots.
From the above discussion, Pyelonephritis results from bacterial urinary tract infection which brings bacteria and white blood cell casts in the urine. Most occurring symptoms of this condition are abdominal pain, fever, burning, and frequent urination. Prerenal acute renal injury is caused by a decrease in renal perfusion, frequently due to volume depletion, Intrinsic is caused by a process within the kidneys while postrenal is caused by inadequate drainage of urine distal to the kidney.
References
Kleeman, C. R., Hewitt, W., & Guze, L. B. (1960). Pyelonephritis. Journal of the American Medical Association , 173 (3), 257-259.
Mehta, R. L., Kellum, J. A., Shah, S. V., Molitoris, B. A., Ronco, C., Warnock, D. G., & Levin, A. (2007). Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Critical care , 11 (2), R31.
Nicolle, L. E. (2008). Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis. Urologic Clinics of North America , 35 (1), 1-12.
Roberts, J. A. (1991). Etiology and pathophysiology of pyelonephritis. American Journal of Kidney Diseases , 17 (1), 1-9.
