The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The diagnosis of acute pyelonephritis is not difficult to determine based on systemic manifestations, urinary tract system disease, increased urine leukocyte count, and positive urine cell examination. However, it needs to be differentiated from acute lower urinary tract infection, especially cystitis, because they have different treatment principles and different prognosis, as the following can be distinguished: (1) Those with positive urinary antibody package bacterial examination are mostly pyelonephritis. (2) Positive bacterial culture of urine specimens after bladder sterilization is pyelonephritis, and negative is cystitis; (3) Referring to clinical symptoms, those with fever (>38 degrees Celsius) or back pain, painful percussion in the kidney area, or a tubular pattern of white blood cells in the urine are more likely to be pyelonephritis; (4) Those who relapse within six weeks after the disappearance of symptoms after treatment are more likely to be pyelonephritis, or those who fail to respond to single-dose antibacterial therapy or Those who relapse are more likely to have pyelonephritis. The diagnosis of chronic pyelonephritis can be based on (1) a history of urinary tract infection for more than one year, and persistent bacteriuria or frequent recurrence; (2) after the disappearance of symptoms with treatment, there is still reduced renal tubular function (such as poor renal concentration function, low specific gravity of urine, decreased excretion rate of phenol red, etc.); (3) X-ray imaging confirms the presence of pelvic calyces deformation, irregular kidney shadow or even shrinkage. In the absence of such obvious evidence, it is more difficult to confirm the diagnosis. Differential diagnosis of pyelonephritis: (1) Renal and urinary tract tuberculosis is an infection of the kidney and urinary tract caused by Mycobacterium tuberculosis. Symptoms, signs, and urinary changes can be similar to those of chronic pyelonephritis, but the difference is that in renal and urinary tract tuberculosis, symptoms of urinary tract irritation are obvious, acid-resistant bacilli can be found on urine sediment smears (except for contamination with Mycobacterium urealyticum), urine culture is negative for common bacteria but positive for Mycobacterium tuberculosis, and urine nitrite reduction test is negative. Foci of tuberculosis.) In some patients with renal tuberculosis, foci of pulmonary, intestinal and abdominal cavity, bone, prostate, paratesticular or pelvic tuberculosis may be found. (2) Urethral syndrome, a common lower urinary tract disease in women, has obvious urinary frequency, urinary urgency, difficulty in urination and other urinary tract irritation symptoms, but mostly no systemic manifestations, no lumbago, no upper ureteral point, no pressure pain at the lumbar point of the ribs, no percussion pain in the kidney area, no increase or slightly increase in the number of white blood cells (usually <10/HP) in the middle urine examination, multiple urine bacterial culture colony count < 10×107/L (105/ml), symptoms gradually disappear after 2-3 days, but are prone to recurrence, part of the syndrome may be pathogenic infection, and the other part may be non-infectious disease. (3) Chronic glomerulonephritis chronic. Glomerulonephritis has no obvious symptoms of urinary tract irritation, the increase in the number of leukocytes in the urine sediment is not obvious, there is no leukocyte tubular pattern, the urine bacterial examination is negative, while the urine protein content is high, easily causing hypoproteinemia and more obvious damage to glomerular function. In pyelonephritis, the amount of urine protein is smaller, usually below 1-2g/24 hours, while the impairment of renal tubular function is more pronounced. Based on these characteristics, it is not difficult to differentiate the two. However, in advanced cases, both can have uremia as the main manifestation, and differentiation is sometimes difficult, especially when chronic glomerulonephritis is combined with urinary tract infection. In this case, detailed medical history and past performance are required. The two diseases are combined with their respective clinical characteristics, to analyze, to determine. If chronic glomerulonephritis is combined with an infection, the characteristics of glomerulonephritis can be clearly demonstrated after the infection is controlled by treatment.