Red flags & when to go in person for Kidney Infection (Pyelonephritis) - Triage

Audience: adult

A kidney infection, also called pyelonephritis, is a serious type of urinary tract infection that affects the kidneys. It often causes symptoms like fever, chills, pain in the back or side, nausea, and painful urination. Early treatment is important to prevent complications. Telemedicine can help assess symptoms, provide education, and guide you on next steps. However, certain warning signs or "red flags" mean you should seek in-person medical care promptly. These include very high fever, severe pain, vomiting that prevents taking medicines or fluids, confusion, or signs of dehydration. This guide helps you recognize when to use telemedicine and when to get urgent in-person care. It also offers tips to prepare for a telehealth visit and what to expect afterward. Remember, this information is for education only and not a substitute for professional medical diagnosis or treatment.

Red flags — go in person / ER

• High fever above 39°C (102°F) with chills requires immediate in-person evaluation.
• Severe back or side pain that limits movement or worsens needs urgent medical attention.
• Persistent vomiting preventing fluid or medicine intake is a danger sign and needs prompt care.

What telemedicine can do

• Initial symptom assessment for mild kidney infection signs.
• Providing education about kidney infections and self-care steps.
• Guidance on when to seek in-person care or emergency services.
• Prescribing antibiotics if appropriate and safe to do remotely.

What telemedicine cannot do

• Managing severe symptoms such as high fever and intense pain.
• Performing physical exams or diagnostic tests like urine or blood tests.
• Treating complications like dehydration or sepsis.
• Emergency interventions for worsening or life-threatening conditions.

What is a Kidney Infection?

A kidney infection (pyelonephritis) is a bacterial infection that reaches one or both kidneys. It usually starts as a bladder infection that spreads upward. Symptoms often include fever, chills, pain in the back or side, nausea, vomiting, and painful or frequent urination. Early treatment is important to avoid serious problems.

When to Use Telemedicine for Kidney Infection Symptoms

Telemedicine can be useful for initial evaluation if you have mild symptoms like low-grade fever, mild discomfort, or urinary symptoms without severe pain or vomiting. A healthcare provider can ask about your symptoms, medical history, and guide you on tests or treatments to try at home.

Red Flags: When to Seek In-Person Care Immediately

Certain signs mean you need urgent in-person medical evaluation:

If you have any of these, go to an emergency room or urgent care center promptly.

Preparing for Your Telemedicine Visit

Before your tele-visit:

What to Expect After Your Telemedicine Visit

After your tele-visit, you may be advised to:

Follow your provider’s instructions carefully and report any changes promptly.

How to prepare for your tele-visit

• Record your symptoms including start date and severity.
• Have your current medications and allergy information ready.
• Find a quiet, private space with reliable internet or phone connection.
• Have a thermometer available to check your temperature.
• Prepare any questions or concerns to discuss with the provider.

After your tele-visit

• Take prescribed medications as directed, usually antibiotics.
• Drink plenty of fluids to help flush the infection.
• Monitor your symptoms daily for improvement or worsening.
• Seek in-person care if red flags or new symptoms develop.
• Follow up with your healthcare provider if symptoms do not improve within a few days.

FAQs

Can a kidney infection get better without antibiotics?

Kidney infections usually require antibiotics to clear the bacteria. Without treatment, the infection can worsen and lead to serious complications. Always consult a healthcare provider for appropriate care.

How long does it take to recover from a kidney infection?

With proper treatment, symptoms often improve within a few days, but it is important to complete the full course of antibiotics, which typically lasts 7 to 14 days. Full recovery may take longer depending on severity.

Are there ways to prevent kidney infections?

Yes. Drinking plenty of fluids, urinating regularly, practicing good hygiene, and promptly treating bladder infections can help reduce the risk of kidney infections.

When should I go to the emergency room for a kidney infection?

Go to the emergency room if you have high fever with chills, severe pain, persistent vomiting, confusion, or signs of dehydration. These may indicate a serious infection needing urgent care.

Sources

1. Kidney Infection (Pyelonephritis) — MedlinePlus, U.S. National Library of Medicine.
2. Urinary Tract Infection (UTI) — Centers for Disease Control and Prevention (CDC).
3. Pyelonephritis — Mayo Clinic.
4. Pyelonephritis: Diagnosis and Treatment — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for professional in-person medical care. If you have severe symptoms or red flags, seek immediate medical attention.