What is a kidney carbuncle ? How is this disease manifested and why does it even develop? We will answer these and other questions regarding the pathology mentioned in the materials of this article.
basic information
What is a kidney carbuncle? In modern medicine, this term is used to refer to a purulent-necrotic formation, which is formed in the cortical substance of the said organ. The main reason for the development of this disease is the penetration of a bacterial pathogen into the kidneys. This occurs from a distant purulent focus with a blood stream.
It should be especially noted that if the inflammatory process in the kidneys was not cured at the initial stages of its development, then purulent fusion of the outer walls of the developed formation can occur very soon and, as a result, its contents exit with further penetration into the pelvis, brain layers of the kidney or perinephral fiber. According to experts, such complications significantly aggravate the course of the disease.
The main reasons for the development
Why does the primary carbuncle of the kidney occur? This disease develops when a huge number of bacteria enter the organ from the far located purulent focus. As a rule, this occurs through the hematogenous route. Such a process leads to the formation of blood clots in small and large vessels.
If a blood clot forms in only one large vessel, then there will be only one focus of septic infarction in the kidney. If small vessels are involved in this pathological process, then multiple foci appear that slowly merge with each other.
So why does a kidney carbuncle occur? Remote causes of infection that can cause this pathology are:
- osteomyelitis;
- mastitis;
- furunculosis;
- purulent skin lesions;
- paratonsillar abscess ;
- felon.
In the event that the causes of the formation of the pathology in question are associated with pyelonephritis (including acute leaking), a purulent focus can occur due to compression of the vessels (small or large) by inflammatory infiltrate.
Experts say that Proteus, staphylococci and Escherichia coli most often participate in the formation of kidney carbuncle. Also, sometimes combined effects of these bacteria are observed.
Other reasons
What to do when developing kidney formations? This will tell you only an experienced urologist. The clinic and its specialists will help the patient not only diagnose this disease, but also determine the correct and effective treatment tactics.
For what other reasons does the pathology under consideration arise? In isolated cases, this disease is associated with the occurrence of obstacles that worsen the outflow of urine. These may include benign and malignant tumors in the urinary organs, calculi in the ureters and prostate adenoma.
It should be noted that the likelihood of carbuncle formation under the influence of the above factors increases significantly with reduced human immunity.
Appearance of education
What does the carbuncle of the left kidney (or right) look like? Visually, such a formation is a bulge that has a rounded shape. At the same time, it can be seen in its section that it consists of small necrotic tissue sections with small abscesses in them.
Usually in the process of development, the carbuncle passes into the parenchyma of the kidney. As for the base of this formation, it is adjacent directly to the fibrous membrane.
It can not be said that in the inflammatory process that occurs in the kidneys, their membrane and fiber may be involved. If the focus is located in the upper region of the said organ, then the infiltrate is able to pass to the adrenal gland. At the same time, signs of its hypofunction very often develop.
The main symptoms of the disease
What are the symptoms of kidney carbuncle? This disease can have a completely different clinical picture. In some cases, the symptoms of the disease in question are most pronounced. Although it often happens that this pathology does not manifest itself at all.
In the event that urodynamics is not disturbed when a purulent necrotic lesion occurs, the symptoms of this disease are very similar to the course of the usual infection process. In this case, the patient has:
- profuse sweating;
- chills;
- tachycardia;
- temperature increase (up to 40 degrees);
- nausea;
- rapid breathing;
- vomiting
- flatulence.
It should be especially noted that on the first day of carbuncle formation, the patient has no signs of urination disorders. Also, patients do not have severe pain. However, in some people there is only a slight discomfort in the lumbar region. However, in the process of urine testing in such patients, an increased number of leukocytes is detected. In the last stages of the disease, pyuria (i.e. pus in the urine) is also detected.
Other signs of pathology
Where does it hurt if the carbuncle develops in the kidney? Symptoms of this disease partly depend on where the pathological focus is located, as well as on the activity of the inflammatory process and the presence of concomitant abnormalities.
It cannot be said that the clinical picture of the carbuncle is determined by the appearance or absence of complete or partial blockage of the urinary tract.
So where does it hurt with such a disease? According to experts, in the later stages of the disease, the patient has pain in the lower back. Moreover, on palpation of the place of discomfort, a swelling on the back is quite easily detected, in particular from the side of the direct lesion.
Similarity of symptoms
Admission to a urologist, as well as his consultation with the development of renal carbuncle, is a mandatory procedure. This is due to the fact that if treatment was not started on time, then the progression of the purulent process contributes to the development of symptoms of appendicitis.
Very often, the disease in question has signs similar to the clinical symptoms of cardiovascular pathologies, liver damage, and neuropsychomorphic diseases. Such a course of the disease can quite easily lead to an incorrect diagnosis and, accordingly, incorrect treatment, which subsequently complicates the course of the underlying ailment.
Lack of signs
A regular appointment with a urologist, as well as a complete medical examination of the patient, are also necessary because the carbuncle of the kidneys may be asymptomatic or with signs of impaired liver function. This state of affairs can lead to the fact that treatment will not be prescribed on time, and a developing disease will cause thromboembolism of blood vessels in the pulmonary artery or brain.
Diagnostic process
Who should diagnose the disease in question? Such a specialist is a urologist. The clinic in which this doctor is admitted may be private or public. In any case, the process of diagnosing a kidney carbuncle requires a special approach and experience.
Due to the fact that this disease does not have specific symptoms, a diagnosis is possible only if there is local swelling and soreness, as well as radiological data.
According to experts, it is very easy to identify the carbuncle (the causes and treatment are discussed in this article) only if it is combined with damage to the calyx-pelvis system of the kidneys. Also, this disease is diagnosed in the process of urine testing, in which a huge number of white blood cells is detected.
If the carbuncle is localized in the cortical substance of the kidney and the patency of the urinary tract is not impaired, then it is quite difficult to identify the disease.
The process of x-ray examination with such a disease allows you to identify a decreased respiratory excursion of the diaphragm. Sometimes the carbuncle may even look like a tumor.
With ultrasound and computed tomography, such a pathology is often defined as the formation of a round or oval shape. If the carbuncle is large, then in the pyelocaliceal system of the kidney, deformation is detected.
Drug therapy
Preparations from the kidneys and formations in them are sold in many pharmacies. However, taking such medications should only be prescribed by an experienced doctor.
Many experts argue that even after successful therapy of the kidney carbuncle, it can recur. As a rule, this happens if the cause of its occurrence has not been completely eliminated.
If a carbuncle is detected in the early stages of its development, patients may be offered antibiotic treatment, but only strictly under the supervision of a urologist. It should be noted that in most cases, such therapy does not give proper results, since purulent formation significantly complicates blood flow in the kidney, which does not allow antibacterial substances to penetrate the lesion.
Recently, the disease in question began to be treated comprehensively, using not only antibacterial drugs, but also a drug such as Cryoprecipitate. The latter is a kind of concentrated mixture obtained from blood plasma. Treatment with this medicine helps to increase the content of fibronectin in the blood, which subsequently helps to restore blood flow in the affected areas of the kidneys.
Surgery
Most often, after the detection of renal carbuncle, patients are prescribed emergency surgical treatment, which is carried out by lumbotomy. It should be specially noted that the tactics of such therapy depend on the condition of the patient, the type of kidney damage, as well as the quality of work of another paired organ.
If the disease in question destroyed a large area of the kidney, then a person is prescribed a nephrectomy. Usually this method of treatment is indicated for older people.
With organ-preserving surgery, which was carried out in a timely manner, the recovery period of the patient proceeds without any complications. In this case, patients note a decrease in body temperature and the disappearance of other symptoms of the disease.
During the rehabilitation period, antibiotic agents may be prescribed to the patient. By the way, their choice depends on the sensitivity of the detected microorganisms to various medications. Also, such patients are shown laser treatment, detoxification therapy and exercise therapy.