Final answer:
Chronic pyelonephritis can be identified through urinalysis indicating the presence of leukocyte esterase, nitrites, and other markers; imaging studies showing kidney changes; and symptoms such as fever, back pain, and nausea. Proper diagnosis also involves microscopic examination of urine and advanced imaging such as DMSA scan or MAG3 scan. Treatment includes antibiotics and potentially surgery to correct underlying abnormalities.
Step-by-step explanation:
Chronic pyelonephritis is a persistent kidney infection characterized by recurrent or lasting damage to the renal parenchyma. Diagnosis typically involves a combination of urinalysis and imaging techniques. Urinalysis may reveal leukocyte esterase and nitrite levels, indicating an infection. Microscopic examination of urine might show evidence such as proteins, red blood cells, white blood cells, bacteria, cellular casts, and crystals, which also point towards pyelonephritis. Imaging studies such as an abdominal ultrasound or a CT scan may show changes in kidney size, scarring, or the presence of obstructions.
Patients with chronic pyelonephritis often present with symptoms such as fever, back pain, nausea, and vomiting. Moreover, the detection of blood in the urine (hematuria) or impaired kidney function may be present. Advanced diagnostic tools like Dimercaptosuccinic acid (DMSA) scans or Mercaptoacetyltriglycine (MAG3) scan chelated with Technetium-99 can help evaluate renal function and structure more closely.
Treatment typically includes long-term or high-dose antibiotics, and sometimes, surgery is required to correct any anatomical anomalies that contribute to the chronic nature of the infection.