Pyelonephritis is an infectious inflammatory disease in which the renal pelvis, kidney parenchyma and calyx are affected.
Pyelonephritis provokes any microorganisms, in particular, Escherichia coli, enterococci and staphylococci. The causative agent enters the kidney from the focus of a chronic infection in the body or through the ureter when urine outflow is disturbed.
Pyelonephritis: signs
Acute pyelonephritis is manifested by common symptoms, such as weakness, pain throughout the body, chills with high fever (up to 40 ° C), nausea, decreased appetite. Along with this, local symptoms are observed - pain in the lumbar region, dysuria. Urine becomes cloudy, flakes may appear in it. Palpation in the kidney becomes painful, the muscles of the anterior wall of the peritoneum tighten, a positive symptom of Pasternatsky (striking) occurs and blood counts deteriorate.
The soreness that occurs when the lumbar region is striated is one of the most common signs of kidney disease. It is determined by applying light blows to the lumbar region alternately from two sides in the rib-muscle corner. Pasternatsky’s symptom is usually determined when the patient is standing or sitting. The pain indicates that the symptom is positive, which is explained by the concussion of paranephria and the affected kidney. However, a positive symptom of Pasternatsky can also appear with diseases of neighboring organs.
Ultrasound examination can detect an increase in the size of the kidney, compaction and thickening of its parenchyma, while the pelvis and calyx expand.
Complications of acute pyelonephritis
The acute course of the disease is often accompanied by bacterial shock due to the massive exposure of toxins to the body, renal papilla necrosis, paranephritis, urosepsis.
The patient should urgently be hospitalized in the urological or surgical department and appoint bed rest. Treatment aims to restore impaired urine outflow and relieve inflammation.
With timely diagnosis and treatment of the acute course of pyelonephritis, recovery occurs.
Chronic pyelonephritis
Pathology becomes chronic after an acute course. The disease is detected by examination of urine by accident or during a detailed examination due to suspected urolithiasis. A survey of patients reveals past cystitis and other acute diseases of the urinary tract. Periodic exacerbations are manifested by subfebrile body temperature, weakness, fatigue, sweating at night, lack of appetite, nausea, vomiting, anemia, earthy complexion, dry skin, hypertension, pain in the lumbar region, impaired urination and urination. Significant changes in urine: leukocyturia, pyuria, bacteriuria, proteinuria, hematuria, cylindruria.
In the treatment of chronic pyelonephritis, foci of chronic infection are eliminated, and full outflow of urine from the kidney is restored. A long antibacterial treatment is carried out, diuretics and immunostimulating agents are prescribed. Timely diagnosis and long-term therapy often lead to a complete recovery.
Children's pyelonephritis
In children, pyelonephritis is considered the most common disease after respiratory diseases.
Pyelonephritis in a child can be unilateral and bilateral, secondary and primary, acute and chronic.
Acute pyelonephritis in a child is serous and purulent, which occurs in the form of a carbuncle, apostematous pyelonephritis or an abscess. Its outcome may be a recovery or a chronic form. Pathology is often complicated by pyonephrosis or wrinkling of the kidney.
With pyelonephritis, a sick child complains of pain in the kidney, which manifests itself on the side of the lesion. The pain is most often dull, sometimes acute attacks occur, which indicates the development of calculous pyelonephritis. The child has a positive symptom of Pasternatsky and general intoxication. To diagnose pyelonephritis, blood and urine are examined, an ultrasound of the kidneys is carried out, and an X-ray is taken. They treat pyelonephritis in children with antibiotics, detoxification and infusion therapy. Physiotherapeutic procedures are indicated.