Medscape is available in 5 Language Editions – Choose your Edition here.


Chronic Pyelonephritis Clinical Presentation

  • Author: James W Lohr, MD; Chief Editor: Vecihi Batuman, MD, FACP, FASN  more...
Updated: Dec 06, 2015

History and Physical Examination

Some children with chronic pyelonephritis may report the following:

  • Fever
  • Lethargy
  • Nausea and vomiting
  • Flank pain or dysuria

The following may be noted on physical examination:

  • Hypertension
  • Failure to thrive in young children
  • Flank tenderness
Contributor Information and Disclosures

James W Lohr, MD Professor, Department of Internal Medicine, Division of Nephrology, Fellowship Program Director, University of Buffalo State University of New York School of Medicine and Biomedical Sciences

James W Lohr, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Society of Nephrology, Central Society for Clinical and Translational Research

Disclosure: Partner received salary from Alexion for employment.


Chike Magnus Nzerue, MD, FACP Professor of Medicine, Associate Dean for Clinical Affairs, Meharry Medical College

Chike Magnus Nzerue, MD, FACP is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Society of Nephrology, National Kidney Foundation

Disclosure: Nothing to disclose.

Anupama Gowda, MBBS, MD Consulting Staff, Peachtree Nephrology, PC

Disclosure: Nothing to disclose.

Chief Editor

Vecihi Batuman, MD, FACP, FASN Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Renal Section, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, International Society of Nephrology

Disclosure: Nothing to disclose.


Richard A Santucci, MD, FACS Specialist-in-Chief, Department of Urology, Detroit Medical Center; Chief of Urology, Detroit Receiving Hospital; Director, The Center for Urologic Reconstruction; Clinical Professor of Urology, Michigan State University College of Medicine

Richard A Santucci, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, and Société Internationale d'Urologie (International Society of Urology)

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

  1. Guarino N, Casamassima MG, Tadini B, et al. Natural history of vesicoureteral reflux associated with kidney anomalies. Urology. 2005 Jun. 65(6):1208-11. [Medline].

  2. Dillon MJ, Goonasekera CD. Reflux nephropathy. J Am Soc Nephrol. 1998 Dec. 9(12):2377-83. [Medline].

  3. Chand DH; Rhoades T; Poe SA; Kraus S; Strife CF. Incidence and severity of vesicoureteral reflux in children related to age, gender, race and diagnosis. J Urol 2003 Oct. 170(4 Pt 2):1548-50. [Full Text].

  4. Birmingham Reflux Study Group. Prospective trial of operative versus non-operative treatment of severe vesicoureteric reflux in children: five years' observation. Birmingham Reflux Study Group. Br Med J (Clin Res Ed). 1987 Jul 25. 295(6592):237-41. [Medline].

  5. Köhler J, Tencer J, Thysell H, et al. Vesicoureteral reflux diagnosed in adulthood. Incidence of urinary tract infections, hypertension, proteinuria, back pain and renal calculi. Nephrol Dial Transplant. 1997 Dec. 12(12):2580-7. [Medline].

  6. Zermann DH, Loffler U, Reichelt O, et al. Bladder dysfunction and end stage renal disease. Int Urol Nephrol. 2003. 35(1):93-7. [Medline].

  7. Alan C, Ataus S, Tunc B. Xanthogranulamatous pyelonephritis with psoas abscess: 2 cases and review of the literature. Int Urol Nephrol. 2004. 36(4):489-93. [Medline].

  8. Gonzalez Resina R, Barrero Candau R, Arguelles Salido E, et al. [Xanthogranulomatous pyelonephritis in childhood. A case report]. Actas Urol Esp. 2005 Jun. 29(6):596-8. [Medline].

  9. Oosterhof GO, Delaere KP. Xanthogranulomatous pyelonephritis. A review with 2 case reports. Urol Int. 1986. 41(3):180-6. [Medline].

  10. Saavedra Jo S, Pow-Sang Godoy M, Benavente Corrales V, et al. [Xanthogranulomatous pyelonephritis: clinical, radiological and pathologic characteristics]. Arch Esp Urol. 2004 Jul-Aug. 57(6):595-600. [Medline].

  11. Zugor V, Amann K, Schrott KM, et al. [Xanthogranulomatous pyelonephritis: presentation of an unusual case]. Aktuelle Urol. 2005 Jun. 36(3):245-8. [Medline].

  12. Arrighi N, Antonelli A, Zani D, Zanotelli T, Corti S, Cunico SC, et al. Renal mass with caval thrombus as atypical presentation of xantogranulomatous pyelonephritis. A case report and literature review. Urologia. 2013 Apr 24. 80 Suppl 22:44-7. [Medline].

  13. F Brown J, Chamberlain JC, Roth CC. The role of laparoscopic nephrectomy in pediatric xanthogranulomatous pyelonephritis: a case report. Case Rep Urol. 2013. 2013:598950. [Medline]. [Full Text].

  14. López JI, Larrinaga G, Kuroda N, Angulo JC. The normal and pathologic renal medulla: a comprehensive overview. Pathol Res Pract. 2015 Apr. 211 (4):271-80. [Medline].

  15. Hiraoka M, Hori C, Tsukahara H, et al. Vesicoureteral reflux in male and female neonates as detected by voiding ultrasonography. Kidney Int. 1999 Apr. 55(4):1486-90. [Medline].

  16. Joshi P, Lele V, Shah H. Fluorodeoxyglucose positron emission tomography-computed tomography findings in a case of xanthogranulomatous pyelonephritis. Indian J Nucl Med. 2013 Jan. 28(1):49-50. [Medline]. [Full Text].

  17. Dracon M, Lemaitre L. [Urinary tract infection in adult. Leukocyturia]. Rev Prat. 2003 May 15. 53(10):1137-42. [Medline].

  18. Noe HN. The long-term results of prospective sibling reflux screening. J Urol. 1992 Nov. 148(5 Pt 2):1739-42. [Medline].

  19. Dell'Atti L. Feasibility and safety of laparoscopic nephrectomy in uremic patients with end-stage renal disease. Urologia. 2015 Nov 19. [Medline].

All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.