Abstract

A PROSPECTIVE OBSERVATIONAL STUDY OF SEPSIS IN PATIENTS WITH PYELONEPHRITIS AT TERTIARY CARE HOSPITAL

Veeruboyana Sujitha*, Konduru Sravani Kumari*, Kommi Lahari*

ABSTRACT

Introduction: PyelonephritisUrinary Tract Infections (UTIs) arecom mon bacterial infections that can impact various parts of theurinary system, including the bladder (cystitis), urethra (urethritis), andkidneys (pyelonephritis). Urinary tract infection normally occurs in theurinary bladder but when it migrates to the k idney or spread throughthe haematogenous way which leads to the inflammation in the Tubuleinterstitial path way involving pelvis and renal parenchyma. Thiscondition is characterized as pyelonephritis. Pyelonephritis leads topermanent kidney damage if n ot treated promptly. Both acute andchronic forms exist, with women being more susceptible than men.Sepsis : Sepsis is a life threatening condition precipitated by anexaggerated immune response to infection, leading to widespreadtissue and organ damage. Despite its criticality, early stages like theSystemic Inflammatory Response Syndrome (SIRS) can bechallenging to diagnose due to its nonspecific symptoms, includingfever or hypothermia,tachycardia, rapid breathing, and alterations in white blood cell counts, in the presence of aninfection. The condition escalates through severe sepsis, characterized by acute organdysfunction, to septic shock, marked by persistent hypotension despite fluid resuscitation,drastically increasing mortality rates. Materi als and Methods Place of Study: The study “aprospective observational study of sepsis in patients with pyelonephritis” which is carried outin the Department of General Medicine and Department of Nephrology at NarayanaHospitals, Nellore a 1440 bedded mul tidisciplinary hospital. Conclusion Our study concludes that predominantly female participants, aged 5060 years, suffer fromemphysematous pyelonephritis, which progress to the second stage of sepsis within a shortduration. This progression is mostly ob served in participants with untreated pyelonephritis.Therefore, increased fluid intake and proper treatment may flush out bacteria from theurethra. These measures are effective in preventing pyelonephritis, which may lead to severesepsis and results in morbidity. Diabetes was a prevalent comorbidity, affecting the majorityof participants, and was notably associated with each type of pyelonephritis. Sepsis was acommon complication, with varying stages observed across different type of pyelonephritis.

Keywords: Prospective observational studies, pyelonephritis, acute pyelonephritis, chronic pyelonephritis, xanthogranulomatous pyelonephritis, emphysematous pyelonephritis, stage 1 sepsis, stage 2 sepsis, stage 3 sepsis.