Chronic pyelonephritis
C/P :

History of recurrent UTI.
Polyurea as the kid. tubules are unable to conc. The urine late oligurea.
Chronic renal failure.

Investig.

Urine + ve culture , pus (few) + WBCs casts.
Sonar shrunken kidneys.

ttt

Ab according to culture for 7-10 days.

2-Then suppressive therapy for 3-6 ms.
With low dose antibiotic (urinary antiseptic)
e.g Amoxacillin 250 mg / d.
Nitrofurantoin 50 mg / d. urinary antiseptic dose
Trimethoprim 100 mg / d.

3-Intravaginal oestrogen therapy has been shown to produce reduction in the number of episodes of U.T.I. in postmenopausal women.

Source: Internal Medicine Book of Dr.Osama Mahmoud (Ain Shams University)