fungal urinary tract infection
Introduction
Introduction to fungal urinary tract infection Fungi that cause invasive infections in humans have been classified into primary pathogens and opportunistic pathogens. Primary infections occur in patients who appear to be healthy or have cell-mediated immune deficiency; opportunistic infections occur in a variety of Causes of phagocytosis in patients, including poor metabolism, chronic wasting disease, hormone or immunosuppressive therapy. basic knowledge The proportion of illness: 0.05% - 0.07% Susceptible people: no specific population Mode of infection: non-infectious Complications: cystitis colon
Cause
Cause of fungal urinary tract infection
(1) Causes of the disease
Primary and opportunistic fungal infections.
(two) pathogenesis
1. The primary fungal infection is caused by dermatitis, phytoplasma, coccidiobacter and other respiratory infections, producing primary lesions in the lungs, when the body's resistance is reduced, or other diseases, it is different Degree of lung infection or systemic infection.
2. The pathogenesis of opportunistic fungal infections is due to the patient's various susceptibility factors, which weaken the body's defense function; leading to opportunistic fungal infections.
Prevention
Fungal urinary tract infection prevention
Control the infection, eliminate the primary disease and susceptibility factors, pay attention to hygiene, cut off the route of transmission, can effectively prevent the occurrence of this disease.
Complication
Fungal urinary tract infection complications Complications cystitis colon
Various types of urinary tract fungal diseases may have different complications, such as large fungal balls visible in cystitis type, ureteral ureteral obstruction type may have no urine, renal pelvic fluid, etc.; fistula type may appear bladder colon fistula, urinary tract skin fistula .
Symptom
Fungal urinary tract infection symptoms Common symptoms Collection tube or nipple... Urine turbid urgency pyuria urinary frequency urinary blood urinary cold ureteral obstruction
The disease can be asymptomatic and only pyuria, can also be a typical urinary tract infection, and even renal failure, there are systemic fungal infections, often have fever, chills and other systemic symptoms, urinary tract fungal disease has the following types :
1. Pyelonephritis type: its clinical manifestations are similar to bacterial pyelonephritis, which can be acute or chronic. There are two main forms: one is multiple renal cortical abscess; the other is collecting duct or nipple diffuse fungal infiltration, which can have nipple Necrosis, these two forms often appear at the same time, often accompanied by fungal ball formation.
2. Cystitis type: more common in women, often secondary to bacterial cystitis after curing, the main symptoms are frequent urination, urgency, nocturia, urine turbidity or hematuria, occasional gasuria (due to urine in Candida to urine) Due to the fermentation of sugar, sometimes large fungal balls are visible in the bladder, and granuloma is formed.
3. Ureteral obstruction type: caused by the fungal ball, the fungal ball migrates to the ureter, renal colic can occur, if the bilateral ureter is completely obstructed, there will be no urine, renal effusion and so on.
4. Kidney papillary necrosis: clinical manifestations and general renal papillary necrosis, due to nipple necrosis, IVP can be seen in a number of irregular small holes.
5. fistula type: There are reports of dermatitis buds, histoplasma, cryptococcal urinary tract infection can occur in the bladder colon fistula, urinary tract skin fistula.
Examine
Examination of fungal urinary tract infections
There is currently insufficient information to provide a standard for distinguishing between normal urinary tract fungal colonies and fungal infections.
1. Generally, the limit of urinary tract fungal infection is: urinary fungus quantitative culture 100,000 colony number, often fungal urinary tract infection, and unprecipitated fresh catheterization microscopy, 10 fields of view On average, there are 1 to 3 fungi/HP, which is equivalent to the number of colonies 10,000/ml, which is diagnostic. The correctness is 80%. The fungus is very slow at room temperature, and its division period is usually more than 5h. Therefore, the urine to be tested can be left for a long time without increasing the number of fungi.
2. Schonebeck believes that in male clean mid-stage urine specimens or female catheter-guided specimens, positive fungal culture means urinary tract fungal infection, and Candida exists in urine in the form of yeast and fungal silk. It is believed that the presence of fungal silk means invasion, but it is still controversial. The determination of serum anti-candida antibody (serum precipitin, lectin, etc.) is helpful for diagnosis. The positive rate of serum precipitin in patients with renal candida infection is 83. %, but there are about 10% false positives.
3. Fungal urinary tract infection can be played by blood source or by ascending infection. If the infection is confined to the urinary system, it is mostly ascending. Therefore, fungal vaginitis and intestinal fungal infection are easily accompanied by urinary tract fungi. infection.
4. Cystoscopy, through the skin and urethra biopsy to help diagnose.
Diagnosis
Diagnosis and identification of fungal urinary tract infection
Rely on pathogen examination and identification of trichomonas urinary tract, mycoplasma, chlamydia and other bacterial urinary sensations.
