ACUTE PYELONEPHRITIS AND VESICOURETERAL REFLUX

Key words: Pyelonephritis, Urinary tract infection, Vesicoureteral reflux, Diagnosis

There is no consensus on the most cost-effective approach to the diagnosis of acute pyelonephritis (APN) and on the best therapeutic approach to vesicoureteral reflux (VUR). Not enough attention is payed to the diagnosis of urinary tract infection, while there is an excess of diagnostic procedures to confirm APN and to search for VUR. Available evidence shows that fever and abnormal urine analysis are sufficient to make the diagnosis of APN. Ultrasonography can further restrict the indications to cystourethrogram. A conservative approach to VUR is effective in the great majority of cases.