Posted by admin | 2017-08-22
The disease occurs in women of childbearing age, the proportion of men and women is about 1:8., clinical manifestations include the following four groups
That is usually referred to the lower urinary tract infection. Adult women cystitis is mainly urinary tract irritation, namely frequent urination, urgency, dysuria, leukocyturia, I may have even hematuria, hematuria, bladder area can have unwell. In general no obvious systemic symptoms of infection, but few patients with lumbar pain, fever (generally not more than 38 DEG C), white blood cell count is not increased. More than 30% cystitis is self limiting, to heal within 7~10 days.
Two, acute pyelonephritis:
Performance includes the following two symptoms: the urinary symptoms include frequent urination, urgency, dysuria, bladder irritation, pain and (or) abdominal pain. The systemic symptoms of infection such as fever, chills, headache, nausea, vomiting, loss of appetite, often accompanied by elevated white blood cell count and erythrocyte sedimentation rate increased fast. Without hypertension and azotemia.
Three, chronic pyelonephritis:
The clinical course of chronic pyelonephritis is hidden. Clinical manifestations are pided into the following three categories: the urinary tract infection: only a few patients with intermittent symptoms of acute pyelonephritis, but more commonly manifested as intermittent asymptomatic bacteriuria, and (or) intermittent symptoms of urinary urgency, urinary tract infection, abdominal discomfort and (or) intermittent fever. The chronic interstitial nephritis, such as hypertension, polyuria, nocturia increased, prone to dehydration. The manifestations of chronic kidney disease.
Four, atypical urinary tract infection:
The main symptoms of acute systemic infection, and urinary tract symptoms was not obvious. The urinary tract symptoms was not obvious, but mainly for acute abdominal pain and gastrointestinal dysfunction. The symptoms of hematuria, mild fever and pain as the main symptoms. 4 no obvious urinary tract symptoms, back pain or lumbago only the minority performance. Performance for renal colic, hematuria, no clinical symptoms, but the urine quantitative bacterial culture, colony 105/ml. urine bacterial quantitative culture negative, is now part of clear cause of acute urethral syndrome.
Among women with urinary tract infection, 40% to 50% of patients are acute urethral syndrome, and women with this syndrome can be pided into 2 groups clinically:
1, (1) pyuria and true urinary tract infections: acute urethral syndrome about 70% women, there is a urine test pyuria and true urinary tract infections, such as Chlamydia trachomatis or patient most common non pathogenic bacteria such as Escherichia coli, Staphylococcus saprophyticus infection, the bacteria number is less than the number of bacteria (100 ~ 10 thousand /ml), the other patients for urethral tuberculosis, fungal infections, or rare abdominal or pelvic abscess caused by adjacent urethral inflammation, treatment can take doxycycline (DOX) 0,1g, 2 /d, 7 ~ 14 days of treatment, relapse for 6 weeks, at the same time to treatment the spouse.
(2) no pyuria and pathogens exist: the remaining 30% acute urethral syndrome women have acute urethral syndrome, but without pyuria and pathogens, that these symptoms may occur with sexual trauma, injury, local irritation or allergies (such as contraceptive medicine, organic fiber, dye and other allergic underpants. Not sure), or other factors, but the need of 3 clean urine bacteria culture, and the exclusion of urinary tract tuberculosis, fungi, anaerobic bacteria, chlamydia, Neisseria gonorrhoeae infection, the treatment of this disease should be checked and remove the factors that may cause the disease, because the disease is most likely some of the symptoms of anxiety neurosis, taking diazepam 2,5mg, 3 /d, oryzanol 10mg and 3 /d, to help alleviate the symptoms.
2, asymptomatic bacteriuria: asymptomatic bacteriuria (asymptomatic, bacteriuria) refers to the presence of urinary tract infection, only occasionally mild fever, fatigue, but repeated positive urine bacteria culture, and the number of colonies is greater than 10 thousand to 100 thousand /ml.
The disease is more common in women, the incidence rate is about 2%, in the past that this is a benign process, without treatment, after a number of studies have demonstrated that long-term asymptomatic bacteriuria will impair kidney function, it should be treated with the same symptoms of urinary tract infections, especially in children, often because of bladder ureteral reflux, asymptomatic bacteriuria caused by upper urinary tract infection, pregnant women with asymptomatic bacteriuria often develop acute pyelonephritis caused septicemia, therefore should begin preventive treatment in the early stages of pregnancy after sexual intercourse, it shall take nitrofurantoin or 0,05g, cephalexin 0,25g, can effectively prevent the urinary tract infection, and has no effect on the mother and fetus.
3, urinary tract infection: the complexity of the concept includes a wide range of clinical syndromes, such as asymptomatic bacteriuria, cystitis, pyelonephritis, dominant urinary sepsis, structural abnormalities in the urinary tract (urethral or bladder neck obstruction, polycystic kidney, ureteral obstruction, catheters and other foreign bodies exist), or (neuronal bladder dysfunction after spinal cord injury, diabetes or multiple sclerosis caused by hereditary kidney disease), urethral or a systemic disease process so that patients are highly susceptible to bacterial invasion and other factors, the patient often had a urinary tract infection, in the presence of pathogenic microorganisms can cause the infection ratio of uncomplicated urinary tract infection is more extensive, and the resistance of these bacteria to antibiotics is common to a large number of people, because of the complexity of UTI diagnosis and treatment methods are different from those of non complicated infection, so the clinical distinction Very important.
4, the huge renal abscess and perinephric abscess: a kidney infection of two kinds of common types of huge renal abscess and perinephric abscess, in the past, the majority of renal abscess secondary to hematogenous infection of Staphylococcus aureus or rare A streptococcal infection, abscess is mainly located in the renal cortex. At present, most of the abscess is secondary to kidney stones, kidney or ureteral obstruction, by Escherichia coli caused by common and typical abscess in the renal medulla, from pre-existing renal cyst infection and the formation of renal abscess is rare, the adjacent parts such as renal abscess or abscess lesions of colon lower ribs caused by local diffusion is rare, renal abscess may extend into the surrounding tissue of kidney.
The clinical manifestations of renal and perirenal abscess is often hidden, fever, weight loss, night sweats, anorexia, chronic inflammatory symptoms associated with abdominal pain and back pain, sometimes due to obstruction and acute clinical manifestations and related bacteremia or showed symptoms such as dysuria, specificity of urinary tract infection, hematuria and obvious urinary retention physical examination can be found, costovertebral angle tenderness, even palpable mass, but 30% to 50% of the patients can be normal, routine laboratory tests can be found that the increase of white blood cell, anemia, urine examination inflammation such as pyuria, proteinuria or both, training to the same bacteria can be more than half of the patients in the when the abscess in the urine, to confirm the diagnosis must rely on excretory urography confirmed renal masses, radioisotope scanning, ultrasonic and CT examination can be found in the kidney or perinephric inflammatory mass, if not abscess With immediate drainage or antibiotic treatment, the abscess can spread to the abdominal cavity, chest, or skin and cause complications
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