It is a well established fact that pyelitis in infancy and childhood is often associated with, or secondary to, infection of the upper respiratory tract. The exact relationship is at present entirely unknown. It has been assumed that the infection of the nose and throat so lowers the resistance of the patient that it permits the colon bacillus to acquire a foothold in the urinary passages, where it then sets up an inflammatory reaction. Furthermore, pyelitis complicating infection of the upper respiratory tract, or other organs, is not caused by the bacteria producing the primary infection, but almost invariably by the colon bacillus.
By what route the colon bacillus reaches the urinary tract is still unknown, in spite of the great amount of work that has been done on the subject. In the many instances in which urinary cultures have been taken in cases of secondary pyelitis, the infecting organism
HELMHOLZ HF, MILLIKIN F. THE RELATION OF INFECTIONS OF THE UPPER RESPIRATORY TRACT TO PYELITIS. JAMA. 1923;81(14):1160–1163. doi:10.1001/jama.1923.02650140004002
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