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Acute pyelonephritis is a bacterial infection of the kidneys causing inflammation, commonly resulting from an ascending urinary tract infection. It typically presents with symptoms such as fever, flank pain, chills, nausea, vomiting, and painful urination. The infection can be uncomplicated in healthy individuals or complicated in patients with underlying conditions like diabetes, anatomical abnormalities, or immunosuppression. Treatment primarily involves antibiotics tailored to local resistance patterns, along with analgesics and antipyretics. Most cases respond to oral antibiotics and can be managed outpatient.

Chronic pyelonephritis is characterized by persistent or recurrent kidney infections leading to scarring, usually associated with anatomical abnormalities or vesicoureteral reflux. It can cause progressive kidney damage if untreated. Management focuses on preventing recurrent infections, addressing underlying urinary tract problems, and sometimes requires surgical intervention.

In summary, acute pyelonephritis is a sudden kidney infection requiring prompt antibiotic therapy, while chronic pyelonephritis involves long-term kidney damage due to repeated infections or structural defects, necessitating ongoing management to prevent renal failure.