Pyelonephritis is a complex inflammatory process of the kidneys. This disease can occur at any age. It is dangerous because it develops very quickly, therefore it requires urgent medical attention.
Pyelonephritis in newborns poses a threat to life, since it can not always be detected in the initial stages. Complications can affect other organs, so the child often ends up in the intensive care unit.
Disease feature
The kidneys play a very important role in the human body. They are responsible for the removal of toxic substances and decay products along with urine.
This body regulates the salt and water balance in the body, is responsible for the production of vitamin D, and also highlights some active components that are responsible for the level of hemoglobin and regulation of pressure. The full functioning of other organs in a child largely depends on the proper functioning of the kidneys. Therefore, it is important to recognize pyelonephritis in newborns in order to prevent the development of complications.
With the course of the disease, not only the kidneys themselves, but also the pelvis, become inflamed. In this case, there is a serious violation of the outflow of urine. This threatens with very serious consequences and various kinds of complications.
Main classification
According to the classification, pyelonephritis in newborns can be primary and secondary. The primary form of the disease occurs without any prerequisites and urological diseases. The infectious process begins to develop in an initially healthy organ. The secondary form of the disease is characterized by the fact that pathology is formed in the presence of inflammation of the urinary tract. This is the most common type of disease.
At the stage of the course, pyelonephritis in a newborn can be infiltrative and sclerotic, and according to localization - one-sided and two-sided. Initially, the child has an acute form of the disease, and the symptoms are quite pronounced. If you do not conduct a comprehensive and timely treatment, then it becomes chronic pyelonephritis.
The disease can occur in a latent form, and in this case, only slightly manifested urinary syndrome. This is the most insidious type of disease, since it is almost impossible to detect it in a timely manner.
Causes of occurrence
The causes of pyelonephritis in newborns are mainly associated with the penetration of pathogens into the kidneys. Often the disease is provoked by Escherichia coli, but many other bacteria can act as a pathogen, in particular, enterococci, Klebsiella, Proteus. They penetrate the kidneys through the circulatory system, lymph, or from the urethra.
Most often, pyelonephritis of the kidneys in newborns develops due to the penetration of bacteria in an ascending way. They come from the perineum and rectum. Skid bacteria contribute to improperly carried out hygiene measures, as well as a sharp weakening of the immune system. In the presence of predisposing factors, the infection rises into the bladder, and then penetrates the kidneys.
Causes of pyelonephritis in a newborn boy may be associated with the presence of other diseases. In this case, the affected bronchi, tonsils, umbilical process, and pharynx serve as a source of infection. Against the background of a weakened immune system, bacteria enter the bloodstream and then spread to the kidneys.
Very rarely, the infection spreads via the lymphogenous route. This occurs with damage to the urinary tract mucosa and the spread of bacteria from the rectum. There are several causes of pyelonephritis in newborns, in particular such as:
- congenital pathologies of the structure of the urinary system;
- pregnancy pathology;
- violation of the composition of urine;
- prolonged hypothermia;
- the presence of inflammatory diseases;
- feeding with artificial mixtures;
- the presence of worms;
- some concomitant diseases.
In the case of advanced acute inflammation, chronic pyelonephritis occurs. The disease develops against the background of the lack of proper treatment or taking ineffective antibacterial drugs. Chronization can sometimes be triggered by certain congenital pathologies of the immune system.
Symptoms of the disease
Symptoms of pyelonephritis in newborns are quite specific. Breasts cannot indicate pain and describe their feelings. Parents guess about the pathology only by indirect symptoms.
The most characteristic sign of pyelonephritis is an increase in temperature to 38-39 degrees. In a 3-month-old baby, the fever is more pronounced, and the temperature can rise to 40 degrees. The course of the disease without fever is characteristic of premature babies.
In addition, the baby is very anxious. The skin of the newborn acquires a painful pale shade. The kid refuses to consume food and begins to lose weight dramatically. Nausea and diarrhea may join the clinical picture.
In some cases, parents with pyelonephritis in a newborn boy note a violation of urination. The jet becomes intermittent and weak.
The disease is also characterized by a change in the quality of urine. A cloudy precipitate forms in it. The urine may also contain minor impurities of the blood and have a rather unpleasant odor. An exacerbation of the chronic form of pyelonephritis has exactly the same symptoms as the acute course of the disease. The period of remission is characterized by a complete absence of signs of the disease. Sometimes such a pathology is accompanied by a constant slight increase in temperature.
Diagnostics
To diagnose pyelonephritis in newborns, when the first signs of the disease appear, parents should consult a pediatrician who, after the examination, refers to a nephrologist. If the assumptions regarding the presence of pyelonephritis are confirmed, the nephrologist gives a referral to a general and biochemical blood test, as well as a urinalysis.
In some cases, ultrasound diagnostics of the urinary system, excretory urography, radiography, and tomography can be additionally prescribed. With a particularly severe course of the disease, a special needle is inserted into the kidney and a subsequent sampling of a small amount of tissue is performed to conduct a morphological study.
Treatment feature
To eliminate the symptoms and causes of pyelonephritis in newborns, treatment must necessarily be comprehensive. When the first signs of illness occur, the baby is hospitalized with his mother in a specialized hospital, where diuresis and the general condition of the baby are traced. Based on this, therapy is selected and adjusted.
Necessarily required specialized medical treatment. In particular, drugs such as:
- antibiotics
- uroseptic;
- antipyretic;
- anti-inflammatory;
- antifungal;
- antispasmodics;
- immunomodulators;
- probiotics;
- herbal remedies.
Inpatient treatment lasts for 3-4 weeks. The drugs are strictly selected by a urologist or nephrologist, giving preference to the most optimal combinations. It is strictly forbidden to independently treat pyelonephritis in newborns, since many drugs are strictly contraindicated in infants or are not effective when taken at the same time.
Drug therapy
The main principle of the treatment of pyelonephritis in newborns is the appointment of effective and rational antibiotic therapy. Before obtaining diagnostic results, doctors prescribe a wide range of drugs. The most commonly used antibiotics are from the penicillin group. These include Amoxiclav, Amoxicillin. In addition, infants are also allowed to take cephalosporins, in particular such as Ceftriaxone, Cefuroxime.
The duration of therapy is 7-10 days. It is strictly forbidden to prematurely cancel the use of drugs, as this leads to a steady growth of pathogenic microflora.
With the ineffectiveness of all these groups of drugs, other antibacterial agents can also be prescribed. Newborns are prescribed macrolides and carbapenems. With a particularly severe course of the disease and the presence of highly resistant pathogens, antibiotics of a wide spectrum of action, fluoroquinolones, aminoglycosides can be shown.
For symptomatic therapy, drugs that normalize the outflow of urine are used. The most popular is Kanefron. Such a drug contributes to a more rapid discharge of infected urine and the death of bacteria. Children are shown taking vitamins. After a course of antibiotic therapy, the use of probiotics is indicated, which help restore the normal intestinal microflora.
If it was proved a fungal infection of the kidneys, then antifungal agents are prescribed in tablet form. During their administration, monitoring of therapy with the help of urography and other techniques is required. After a course of antibiotic therapy, uroantiseptics are prescribed, since this helps prevent the disease from flowing into the chronic stage. These antimicrobials help eliminate the ongoing inflammatory process.
To eliminate puffiness and inflammation, antihistamines are prescribed. In addition, they help stop the signs of allergies if there is a reaction to the antibacterial agents used. In rare cases, with severe kidney damage, surgical treatment may be prescribed.
Compliance
Treatment of pyelonephritis mainly takes place in a hospital and only in some cases at home. Therefore, parents must follow a certain regime for the period of therapy.
It is important to carry out exclusively natural breastfeeding during the treatment process. Of great importance is the observance of thorough hygiene of the newborn.
The flow of the infectious process into the chronic stage is particularly dangerous for the health of the child, and constant exacerbations significantly worsen the quality of life. The prolonged course of pyelonephritis leads to various complications. After suffering an acute form of the disease, mandatory dispensary registration is shown once every 6 months for 5 years.
Possible complications
In the first month of life, the baby’s kidney size is approximately 5 cm. Bacteria very quickly infect this baby’s organ. That is why pyelonephritis progresses very quickly, significantly increasing the risk of complications. This is very dangerous, as it threatens to defeat other organs. The consequences of pyelonephritis in a newborn boy or girl can be such as:
- the transition from acute to chronic;
- hydronephrosis;
- arterial hypertension;
- sepsis;
- necrosis of the tubular system;
- multiple abscesses of the kidneys.
As a result of increased heart load and pressure, hypertension begins to develop. Complications are very serious, which is why, in order to prevent them, you need to consult a pediatrician in a timely manner.
Prophylaxis
The occurrence of pyelonephritis and its complications is quite possible to prevent, the most important thing is to follow certain preventive measures, in particular:
- carefully monitor the hygiene of the newborn;
- wear diapers before going to bed or walking;
- women need to follow a diet while breastfeeding;
- undergo periodic preventive examinations;
- in a cool time it is warm to dress a child;
- maintain immunity;
- if the first signs of the disease are identified, contact a pediatrician immediately.
After previously transferred pyelonephritis, the child must be registered with a urologist. Nephrologist consultations and examinations will also be required. Special care should be taken when administering vaccination. With the occurrence of acute pyelonephritis in a child, the vaccine until one year of age can be delayed until the normal state of health.
If the child has already suffered a disease once, then preventive measures must be taken so that relapses are not repeated. To prevent the development of chronic pyelonephritis, it is extremely important:
- ensure that bladder emptying is frequent and timely;
- to control that the baby sleeps well, drank enough fluid, took vitamins;
- organize frequent walks in the fresh air;
- periodically do a biochemical blood test.
Pyelonephritis is a very serious disease, especially in relation to infants. With incorrect or untimely treatment of the acute form, the disease can go into the chronic stage, which is fraught with dangerous complications and frequent relapses.