Which specialist consultations are indicated for acute pyelonephritis (kidney infection)?

Updated: Jul 01, 2021
  • Author: Tibor Fulop, MD, PhD, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Consultation is indicated if the infection is complicated. Most cases of acute pyelonephritis occur in adult women and are readily managed without consultation. The following are reasons for consulting various subspecialists:

  • A urologist may be consulted regarding patients with ureteral or urethral obstruction, urinary stones, urogenital abnormality, or recurrent pyelonephritis, or for the first episode of pyelonephritis in an infant or child.
  • A nephrologist may be consulted regarding patients with acute kidney injury or advanced chronic kidney failure or for neonates or infants.
  • An infectious disease specialist may be consulted regarding patients with an unusual or resistant pathogen, those who are immunocompromised, patients with persisting fever (>48 hours) or toxicity (> 72 hours), or patients whose blood culture results are positive for more than 48 hours.
  • An obstetrician may be consulted for patients who are pregnant.

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