FEVER DURATION IN HOSPITALIZED ACUTE PYELONEPHRITIS PATIENTS

PURPOSE: TO study persistence of fever in treated pyelonephritis with respect to guidelines recommending investigation and modification of t herapy after 2 to 3 days of fever. PATIENTS AND METHODS: A retrospecti ve chart review was made of 70 patients hospitalized for febrile pyelo nephritis at a community hospital in Canada. RESULTS: Median duration of fever was 34 hours; persistence of fever at 48 and 72 hours was 26% and 13%, respectively. No patients had complications such as intraren al or perirenal abscess. Prolonged fever was independently associated with increasing baseline creatinine (P = 0.0001), younger age (P = 0.0 27), and increasing total leukocyte count (P = 0.026). Results of ultr asonography and intravenous urograms were not predictors of fever dura tion. CONCLUSION: Fever in treated pyelonephritis can take 4 days to r esolve, and routine urologic investigation after 2 to 3 days of fever may be unwarranted.