In the diagnosis of pyelonephritis, a urine test is performed to identify bacteria and formations of white blood cells, called casts, which are shaped like tubes in the kidneys. X-rays are also performed to look for abnormalities in the kidneys, ureters, and bladder.

A urine dipstick test can also determine the presence of a pyelonephritis infection by examining or looking for the presence of nitrite and leukocytes (white blood cells) in the urine. In some case, blood culture may be needed to be clearer about the source of infection.

As with other infections, the most common treatment of pyelonephritis is the use of antibiotics taken for several weeks. For mild cases, oral therapy may be preferred, but intravenous antibiotics are the most commonly used intervention in the starting stages of treatment.

Some of the antibiotics that may used as a form of treatment are as follows: fluoroquinolones, beta-lactam, trimethoprim, or nitrofurantoin. For infections that already caused anatomic abnormalities, surgery may be required.

In cases of very high fevers and leukocytosis, a patient should be brought to the hospital and be allowed to take in intravenous fluids (for hydration). Moreover, intravenous antibiotics must be administered at once.

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During the treatment with the use of different antibiotics, close monitoring of serial white blood count should be followed. Body temperature must also be monitored. The use of intravenously administered antibiotics should not be stopped until the patient has lost his fever for at least 24 to 48 hours. When the patient's temperature returns to normal, then the antibiotics should continue to be administered for a total of about two weeks.

The use of intravenous fluids administration is performed as a fluid replacement because of the patient's reduced intake of fluids and to maximize urine output. After the treatment, there are recommended diets that can be followed to prevent urinary tract infection recurrence.