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Pyelonephritis - E. Coli Kidney Infection

Pyelonephritis sometimes has to be treated with IV antibiotics.

Pyelonephritis sometimes has to be treated with IV antibiotics.

What Is Pyelonephritis

Before last week, I’d never heard about Pyelonephritis. Since then, I’ve done a lot of research about this potentially serious urinary tract infection. What is Pyelonephritis? It’s a kidney infection – a specific type of nephritis, which is the term used to describe inflammation of the nephrons. Nephrons are the tube-like structures in the kidneys that remove waste and water from the blood and create urine. Located at the center edge of each kidney is the pyelum, or renal pelvis. The renal pelvis is shaped like a funnel, and urine flows from the kidney and into the ureter via the pyelum. When the pyelum becomes inflamed, the condition is called pyelonephritis. How did I become so interested in this particular type of kidney infection? I’m trying to learn as much about it as I can because my daughter, Shannon, has it. She was diagnosed last week and had to spend several days in the hospital. And her fight’s not over yet, as it took her doctors a couple of days to find an antibiotic that the infection would respond to. This infection has made her very ill, and I was shocked to discover that in extreme cases, Pyelonephritis can be fatal.

Urinary Tract Infection is usually found through urinalysis.

Urinary Tract Infection is usually found through urinalysis.

Urinary Tract Infection

A urinary tract infection is a viral or bacterial infection of any part or parts of the urinary system: the urethra, the bladder, the ureters, or the kidneys. Urinary tract infections are pretty common, especially for women. That’s because they have shorter urethras, making it easier for bacteria to enter the bladder. A urinary infection can be introduced to the urinary tract through sex, improper bathroom hygiene, spermicides and other irritating substances, and the use of catheters. Sometimes germs in other parts of the body, especially in the lymph system and the blood, can travel to the urinary tract and cause infections.

The most common type of urinary tract infection is cystitis, an infection of the bladder. When I was a kid, I used to get this type of UTI infection when I used bubble bath too often. Cystitis isn’t usually serious if it’s treated promptly, although it can be painful. When the bacteria isn’t killed, however, the infection can spread to the kidneys and cause a kidney infection, which is much more serious.

Shannon and Justin

Shannon and Justin

Kidney Infection

A kidney infection typically starts in the urethra or in the bladder. If not treated properly, the urinary infection spreads to one or both kidneys. If you have an infection anywhere in your body, there’s a chance that it can spread to the kidneys. This works the other way around, too. Kidney infections can spread the invading bacteria to other parts of your body and can even lead to blood poisoning. Symptoms of kidney infection include painful urination, fever, dark or bloody urine, nausea, vomiting, and pain in the back, lower abdomen, or lower side. Someone with a kidney infection might also have to urinate much more than usual.

If you think you might have a kidney infection, seek medical attention as soon as possible. Your doctor can test your urine to find out. If your suspicions are confirmed, you’ll most likely be prescribed an antibiotic to help your body fight the bacteria. Please be sure to take the antibiotics as directed. It’s important to take all the medication, even after you begin to feel better. If you don’t finish your antibiotics, there could still be some bacteria surviving.

The culture and sensitivity test (C & S) identified a resistant strain of E. coli.

The culture and sensitivity test (C & S) identified a resistant strain of E. coli.

Acute Pyelonephritis

Shannon was surprised to find out she had pyelonephritis. She had been feeling bad for a couple of weeks. She’s a nurse, and she felt sure she had a urinary tract infection. It wasn’t her first UTI infection – she’d had them in the past. She had some antibiotics on hand, so she self-medicated. I think nurses often do that. She didn’t get better, however. In fact, she got worse. It got to the point where every day included nausea, vomiting, and pain in her back and sides. When her fever spiked, she finally sought help from a physician, who admitted her to the hospital.

Shannon’s urine was dark reddish brown. A urinalysis showed she had a urinary tract infection, along with blood in the urine. A CT scan revealed that she had acute pyelonephritis in both kidneys. This condition can result in kidney failure, urosepsis, and even death. Urosepsis can result in shock, causing shaking, dangerously low blood pressure, rapid breathing, and delirium. In some rare cases, xanthogranulomatous pyelonephritis can develop from chronic pyelonephritis, and part of the kidney might have to be removed.

E. Coli and other bacteria are becoming resistant to antibiotics.

E. Coli and other bacteria are becoming resistant to antibiotics.


Once Shannon’s medical team diagnosed her with acute pyelonephritis, they had to discover what they were fighting – what virus or bacteria was the cause. They ran a C & S, a culture and sensitivity test. A culture was grown, and the culprit was identified – E. coli. And this wasn’t just any E. coli, either. It was a strain that was very resistant to antibiotics. I’ve never had a kidney infection, so I didn’t really know much about them. I asked how E. coli wound up in a kidney. The health care team believes that Shan probably had diarrhea a few weeks ago, and that some of it splashed from the toilet up onto her urethra, causing a urinary tract infection. Because the infection wasn’t treated properly, it expanded to the kidneys.

The attending physician shared some frightening news with us. He believes that in ten years, there will be strains of E. coli that antibiotic drugs won’t be able to control at all. The bacteria is getting stronger because so many patients don’t finish their round of antibiotics. The weakest bacteria are killed first, and the stronger ones are able to survive longer. Sometimes when patients start to feel better, they stop taking their antibiotics. When that happens, the stronger bacteria are often allowed to survive, and they’ve gained resistance.

Shan's pyelonephritis treatment involves receiving IV Invanz.

Shan's pyelonephritis treatment involves receiving IV Invanz.

Pyelonephritis Treatment

Pyelonephritis treatment can prove challenging. The E. coli causing Shannon’s for example, would not respond to the antibiotics first prescribed. Only a specific antibiotic, Invanz, worked, and it had to be delivered through IV. They placed a PICC line in her inferior vena cava for administration of the drug. PICC stands for peripherally inserted central catheter, and the inferior vena cava is the large vein that brings blood from the lower body back to the heart. The line runs from her right arm, where the port was placed. Once a day, every day, the antibiotic has to be administered through the port.

Invanz is the brand name for ertapenem, a strong antibiotic that works against numerous strains of aerobic and anaerobic microorganisms, including E. coli. The drug is considered pretty safe, but it’s not completely without negative side effects. Invanz side effects can include nausea, headaches, diarrhea, constipation, confusion, swelling, and feminine itching. It might also cause some serious side effects in some patients: convulsions, rash, stiff or painful muscles, and blackouts. In rare cases, a patient might have an allergic reaction to Invanz that could result in breathing difficulties, hives, or swelling of the face, tongue, throat, or lips.

After Shannon had been hospitalized for five days, her physician wanted her to stay for another two weeks. She really didn’t want to do that. She has four small children, and she didn’t want to miss that many days of work, either. Her doctor agreed to release her from the hospital, and a home health nurse would visit every day to give the Invanz – at first.

The first day after going home, a nurse came to Shan’s house to give the dose of Invanz. The next day the nurse came, she explained and displayed how the drug should be given. The next day, the nurse watched Shannon do the job on her own. The nurse was satisfied that Shan was capable of giving herself the antibiotic. The drug is in powder form, and it has to be mixed with saline, in a small bag. Once mixed, the solution is fed into the PICC port. It takes about thirty minutes.

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Shan isn’t on any other pyelonephritis treatment drugs. She’s getting better, although it’s a gradual improvement. She’s still nauseous every day and has lost a significant amount of weight. Ironically, she’s one of the few family members who don’t need to lose at least a few pounds. Nausea is one of the symptoms of pyelonephritis, and it’s also a side effect of the antibiotic, so we’re not sure which is causing the nausea and vomiting. Maybe it’s a combination of the two. I worry about her getting enough protein and calories, so I bought her some Muscle Milk. She’s usually able to keep that down. She also feels physically exhausted most of the time, even though she sleeps a lot. Her mother-in-law has the two younger kids, and the two older kids are at school all day. Shannon’s husband, Justin, is really helping out at home, too. I’m just glad my precious daughter finally found out what was making her so ill and that she’s on the road to recovery. Kidney infections like pyelonephritis can be extremely serious.


Holle Abee (author) from Georgia on December 13, 2015:

Lisa, my daughter has had no more kidney problems at all. Best of luck with your pyelonephritis, and thanks for reading!

Lisa on December 13, 2015:

I just found this story on here. I am going through the same thing right now but I had to go through to rounds of pick line meds I was on the same thing you daughter was on. I go back at the end of dec this year to make sure I hasn't came back. It your daughter ok or has it ever came back. thanks for sharing I am very nervous an worried it may come back.

Holle Abee (author) from Georgia on July 20, 2014:

Selime, I'll never understand what criteria the search engines use! lol. thanks for reading and commenting!

Holle Abee (author) from Georgia on July 20, 2014:

Kelly, I'm so glad you and your mom recovered. Kidney infections are scary, but many people don't treat them with the respect and care they deserve. thanks!

Kelly on July 20, 2014:

I hope your daughter is all well. I had a similar kidney infection over 10 years ago (in middle school) so I didn't tell anyone about my uti symptoms until I threw up in class one day after 2 weeks of pain. 48 hours later I was in the ER in the worst pain of my life for 12 hours of testing until I finally got a diagnosis and a morphine drip. After 6 days of meds in the hospital I left with a PICC line. I was 12 so I didn't ask questions of why it was so intensive on treatment but after 2 more weeks I finally got better. My antibiotics were in a dose timed balloon inside a hard case that I just hooked up every day. So glad it was simple because I aside from the pain, severe pain and diagnosis, a lot of it is a blur.

I didn't know at the time that things like sepsis existed and if I hadn't been treated I easily could have been dead in a week.

My mother had septic shock a few years ago and after 3 weeks in the ICU she made it through.

So thanks for writing about your daughters experience and the severity of it so people can know. I'm glad the horror of thor painful weeks aren't just made up in my head!

Again I hope all is well with your family.


Selime on August 02, 2013:

I have been seeking this info for some time. After four and a half hours of onlnie finding, luckily I saw that in your article. I wonder why Bing don't rank this sort of useful web sites in the first page. Normally the first few web sites are junks. Perhaps it's time to use other search engine.

Holle Abee (author) from Georgia on March 12, 2013:

Thanks, teach! I think Shannon is getting better with each passing day.

Dianna Mendez on March 11, 2013:

Oh my, sorry your sweet daughter had to endure such suffering. Glad that she found the remedy and that she is on her way to recovery. Thanks for sharing this information which will be useful to those who may have this infection.

Holle Abee (author) from Georgia on March 09, 2013:

Thanks, Prasetio! I love how you always support your fellow Hubbers.

prasetio30 from malang-indonesia on March 09, 2013:

Very informative hub and I learn many things from you. It looks horrible. Thanks for writing and share with us. Voted up!


Holle Abee (author) from Georgia on March 08, 2013:

Thanks, Doc. I think they make a great couple!

drbj and sherry from south Florida on March 08, 2013:

What a nasty infection this is, Holle. Shannon is a lovely looking young woman and I hope she is rapidly recovering from her kidney infection. Justin is cute, too. ;)

Holle Abee (author) from Georgia on March 08, 2013:

Carol, that sounds really scary! Thanks a bunch for stopping by!

Holle Abee (author) from Georgia on March 08, 2013:

Graham, you are a dear!

Holle Abee (author) from Georgia on March 08, 2013:

Thanks, vocal. She is a pretty girl, but she looks pretty bad now. Good to see you again!

Holle Abee (author) from Georgia on March 08, 2013:

Cluck, thanks for the prayers - and thanks for reading!

Holle Abee (author) from Georgia on March 08, 2013:

Mac, I agree with your take on UTI infections. I know now what can happen when they're ignored. A simple bladder infection can turn into a serious kidney infection.

Carol from Greenwood, B.C., Canada on March 08, 2013:

Wow! This sounds terrible - especially for a mom with young kids. It's hard to take time for yourself when you are so needed at home. I hope she feels much better soon.

My mom had a serious kidney infection a few years ago. She was in the hospital for quite a while and before she got better the whites of her eyes turned lime green! It was very scary. She had an NDE during this illness. I really should write about that!

I'm sending prayers that you all get well soon!



Graham Lee from Lancashire. England. on March 08, 2013:

Hi habee. You are certainly having a rough time at present with both yourself and your daughter attending hospitals. I hope there is an improvement in things for both of you very soon - keep smilin'


Holle Abee (author) from Georgia on March 07, 2013:

And I'm still accepting 'em, Sis! I figure we need all the help we can get. Thanks!

Holle Abee (author) from Georgia on March 07, 2013:

Wetnose, Justin has been great. We've all pitched in to help. My hubby picks the girls up from school, and I've done some cooking for them - when I could. I can't do a lot with this bum knee. My oldest daughter has helped some, too. The youngest daughter is just getting over her emergency appendectomy. When it rains...

Audrey Hunt from Pahrump NV on March 07, 2013:

Dear Habee - Sure hope your knee is continuing to heal and that you're regaining strength in that area. About Shannon. First, she is beautiful! Second, I can't imagine how sick she has been with the kidney infection. I've not heard of Pyelonephritis and very glad you've educated me.

Your family has really been through a tough time. Sure hope Shannon recovers from this and soon. I believe in the power of prayer and will get down on my knees. Best wishes and thoughts .

Christina from Oklahoma on March 07, 2013:

Very helpful article. I have had bladder infections and I know they are painful. I cannot imagine how your daughter feels. I will say a prayer for her. I have self medicated as well and after reading this, I think I will go to the doctor if I ever get another bladder infection.

Wendy Golden from New York on March 07, 2013:

I'm glad your daughter is on the mend. This infection sounds like a nightmare. The antibiotic resistant bacteria could become a real health crisis in the future. I hope your daughter makes a full recovery quickly. Thanks for a very informative hub - urinary tract infections are not taken nearly as seriously as they should be.

Angela Blair from Central Texas on March 07, 2013:

What a debilatating experience for Shan -- know you've been so worried about her. What a blessing they found an antibiotic that worked -- had the "trying to find" stage been prolonged that would indeed have been another set-back. Best wishes to Shan, her family and you and Papa -- what with your knee surgery I know you've had a rough road here. Prayers do work and I'm still sending 'em. Best/Sis

wetnosedogs from Alabama on March 07, 2013:

Oh boy. Prayers for your daughter in healing well. I hope that her job is patient and willing to have her back when she is able. Bravo for her husband in helping out.

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