Pyelonephritis is a bacterial infection that affects kidney tissue and often the renal pelvis. This page summarizes how the infection develops, common symptoms, factors that increase risk, and when to seek specialist assessment or urgent care.
Pyelonephritis occurs when bacteria enter the urinary tract and migrate upward into the kidneys. It may affect one or both kidneys and can recur in some people. Structural differences of the urinary tract, obstructions that disrupt urine flow, or a weakened immune response increase the chance of kidney infection.
Typical symptoms include fever, chills, pain in the flank or lower back, and burning or frequent urination. Nausea, vomiting and a general sense of being unwell can accompany the infection. Some people report blood in the urine or unusually foul-smelling urine. Because these symptoms can overlap with other conditions, clinical assessment helps determine the cause.
Risk is higher in people assigned female at birth due to urinary anatomy, during pregnancy, with urinary stones or obstruction, when using a urinary catheter, or with impaired immunity. Initial evaluation usually includes a symptom history, physical examination and urinalysis; a urine culture and imaging (ultrasound or CT) may be used when complications or atypical features are suspected. Referral to urology or nephrology can be useful for obstructive problems, recurrent infections, or complex cases.
Maintaining adequate hydration, attentive personal hygiene and prompt assessment of lower urinary tract infections can reduce the risk of progression to the kidneys. Seek urgent medical evaluation if severe fever, intense flank or abdominal pain, persistent vomiting, difficulty urinating or altered mental status occur, as these can indicate a serious infection requiring immediate attention.
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