198 cases of acute pyelonephritis, admitted to the Department of Internal Medicine, NMC, for the six years and a half from Jan. 1971 to June, 1976, were reviewed for the analysis of their clinical and laboratory features, and the following results were obtained.
l. The highest age incidence of acute pyelonephritis was the third decade (63 cases, 31.8%), followed by 4th decade (55 cases, 27.8%), 5th decade (38 cases, 19.2%) in order, and 78.8% of all cases studied were between the 3rd & 5th decade.
The sex incidence was 1 to 8.9, with female predominance.
2. In the clinical manifestation, the commonest symptom was fever and chill (125 cases, 88.4%), and the next was flank pain (114 cases, 57.6%), followed by headache (57 cases, 28.8%), vomiting (34 cases, 17.2%), nausea (30 cases, 15.2%), and dysuria (30 cases, 15.2%) in order of frequency.
3. The number of patients with certain precipitating factors or associated diseases, was 66 (33.3%) of 198 cases, and the order in frequency was pregnancy (17 cases, 8.6%), typhoid fever (10 cases, 5.1%), septicemia (9 cases, 4.6%), diabetes mellitus (8 cases, 4.0%), and urinary tract obstruction (7 cases, 3.5%).
4. The duration of fever after hospitalization was mostly less than 5 days (126 of 166 cases, 75.9%), and the number of patients with the duration more than 8 days was only 9 cases (4.8%).
5. The number of positive results in urine culture was 136 of 198 cases (68.7%), with the most frequent causeating microorganism, E-coli (93 cases 65.5%), followed by Coliform bacilli (15 cases, 10.6%), Klebsiella (10 cases, 7.0%), Paracolon bacilli (7 cases, 4.9%), and Enterococcus (6 cases, 4.2%) in order. The commonest causeating microorganism in female patients was E-coli (69.3%), and in male, was Klebsiella (40%) and E-coli (33.3%).
6. In the sensitivity test of causeating microorganisms to antimicrobial drugs, E-coli was highlysensitive to furadantin (80.7%) and kanamycin (54.8%), Coliform bacilli and Klebsiella showed the sensitivity to furadantin 66.7% and 60% respectively, Paracolon kacilli showed the sensitivity tokanamycin (100%) and furadantin(57.1%), proteus mirabilis, to aminoglycosides such as kanamycin, gentamicin, and streptomycin, and Pseudomonas was sensitive only to gentamicin.
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