Differential diagnosis of chronic pyelonephritis

When no acute pyelonephritis symptoms ( fever and back pain ) exists , urinary tract and urinary tract infections often very difficult on the identification. Chronic pyelonephritis patients with renal scars in typical excretory urography in patients with lower urinary tract infection and kidney is normal. However, patients with renal scarring and sometimes urine culture no bacterial growth , only the performance of lower urinary tract infection symptoms. Patients with normal excretory urography also sometimes fever, back pain or other symptoms of upper urinary tract infection . Therefore , when invasive procedures unless otherwise lower urinary tract infections ( cystitis female urethral syndrome and male bacterial prostatitis and cystitis ) and upper urinary tract infection between identification difficult .
    Chronic interstitial renal disease and chronic pyelonephritis must be differentiated from other causes , particularly analgesic nephropathy . Must be considered when making the identification of possible renal tuberculosis , urine smear and culture found mycobacteria and can be identified when urography found the typical manifestations of renal tuberculosis . Urography found to have chronic pyelonephritis change , sometimes the need for further examination of renal scintigraphy with kidney tumors , angiography or CT scan phase identification.