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Acute pyelonephritis is a sudden and severe bacterial infection of the kidney and renal pelvis, often resulting from an ascending urinary tract infection. It usually presents with symptoms such as high fever, chills, flank or back pain, nausea, vomiting, and painful or frequent urination. The infection causes inflammation in the kidney tissues and can lead to complications like impaired renal function or sepsis if not treated promptly. The most common causative bacteria are gram-negative organisms like Escherichia coli. Diagnosis involves clinical symptoms and urine tests including cultures. Treatment typically requires antibiotics that effectively reach kidney tissues, and in complicated cases, hospitalization may be necessary.

Timely treatment usually results in full recovery, though recurrent or untreated infections can cause chronic kidney damage. Risk factors for complicated cases include urinary tract abnormalities, immune suppression, diabetes, and multidrug-resistant bacteria. In children and older adults, symptoms may vary and can include confusion or lack of typical signs. Preventing recurrence involves managing underlying urinary issues and using appropriate antibiotic therapies.