MODE OF INFECTION
In all infectious diseases bacteria enter the blood and pass out through the kidneys. If they are few and not especially virulent no infection takes place, but if they are abundant, attached to débris which has become separated from the purulent focus in which they have their origin, of virulent strain, and one or both kidneys are injured or diseased, and there is a concomitant obstruction to the free exit of urine from the kidney, either temporary or permanent, a renal infection which may cause a severe and overwhelming toxemia and rapid death, or a slower type with or without suppuration, will surely result.The required elements for the production of renal infections of a hemic source are the presence of pus-producing organisms and a lowered local resistance in one kidney. The first is supplied by a focus of infection always, the second by a traumatic injury
MacGOWAN G. HEMATOGENOUS KIDNEY INFECTIONS. JAMA. 1915;LXIV(3):226–231. doi:10.1001/jama.1915.02570290038010
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