parasitic urinary tract infection
Introduction
Introduction to parasitic urinary tract infection Parasitic urinary tract infections include trichomonad urinary tract infections, urinary filariasis, urinary amebiasis, and echinococcosis, which are clinically affected by their infectious agents, pathogens, and routes of transmission. The lesions vary. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of transmission: insect vector transmission Complications: chyluria, pulmonary hydatidosis, urticaria, asthma, abdominal pain, anaphylactic shock
Cause
Cause of parasitic urinary tract infection
Trichomonas urinary tract infection (20%):
The main pathogen of urinary tract infecition caused by trichomonas is vaginal trichomoniasis, which can parasitize in the vagina, urethra and male urethra and prostate, causing vaginitis, urethritis, prostatitis, bladder Inflammation, etc., can even invade the kidneys, and even cause perirenal abscesses, the main route of infection is ascending.
Urinary amebiasis (18%):
Amebiasis of urinary tract refers to a disease caused by the invasion of the kidney, bladder, and urethra by amoeba in the lytic tissue. This disease is often caused by amebic enteropathy and amoebic liver abscess.
Urinary filariasis (18%):
Lymphangiitis and lymphatic obstruction caused by adult worms, larvae and their metabolites, occur in the limbs, forming elephantiasis, hydrocele and local lymphatic vessel expansion.
Kidney echinococcosis (15%):
Hydatidosis (echinococcosis) is a disease caused by the infection of human larvae of Echinoeococcus gransosus.
Pathogenesis
See the Infectious Diseases section.
Prevention
Parasitic 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
Parasitic urinary tract infection complications Complications, chyluria, echinococcosis, urticaria, asthma, abdominal pain, anaphylactic shock
Urinary filariasis can be complicated by limb elephantiasis, commonly known as "like skin legs"; urinary filariasis can be seen with obvious chyluria, renal hydatid cysts enlarge, oppress the surrounding glomeruli, causing it to shrink and rupture, even If a cyst penetrates into the renal pelvis or abdominal cavity, it can cause allergic symptoms such as urticaria, asthma, fever and abdominal pain. In severe cases, anaphylactic shock can occur.
Symptom
Parasitic urinary tract infection symptoms Common symptoms Fingernails have white spots, low back pain with frequent urination, urine... Urinary tract sensation leucorrhea increased abdominal pain, tension, high fever, cold tremor, shock
Trichomonas urinary tract infection
The clinical manifestations are exactly the same as bacterial urinary tract infections. Female patients are often manifested as vaginitis: increased vaginal discharge, genital itching, and even vaginal itching. There may be lower urinary tract symptoms: frequent urination, urgency, dysuria, and urinary tract after urination. Burning sensation and other urinary tract irritation are the main symptoms; male patients are often accompanied by balanitis, most of the lower urinary tract infections discharge a small amount of purulent secretions in the morning urine, urinary tract itch, bladder involvement, discomfort in the upper part of the pubic bone, often Terminal hematuria, a small amount of milky white secretion after urination, trichomonas pyelonephritis with chills, fever, abdominal pain, pyuria and hematuria, some patients may have no systemic symptoms and urinary tract irritation.
2. Urinary tract amoebiasis
Depending on the site of infection and the route of infection, the clinical symptoms are not specific, similar to common bacterial urinary tract infections, and are classified into the following types according to the clinical manifestations of the lesion:
(1) Amebic cystitis, urethritis: caused by intestinal bladder spasm or upper urinary tract infection, frequent urination, urgency, dysuria and bladder pain before and after urination, and kidney infection, may have chills, High fever, low back pain, sore throat in the kidney area.
(2) Amoebic renal abscess or perirenal abscess: caused by blood infection or liver, colonic amoebic abscess pierced to the kidney, the main clinical manifestations of chills, fever, low back pain, kidney tenderness and cramps, The lumbar muscles in the kidney area are tense and may touch local tumors.
3. Urinary filariasis
Filariasis is a lymphangiitis and lymphatic obstruction caused by adult worms, larvae and their metabolites. It occurs in the extremities, forming elephantiasis, hydrocele and local lymphatic vessels, and some patients develop sperm. Su Yan, epididymitis and orchitis, if the lesion obstructs the thoracic duct or chyle, the distal lymphatic vessels rupture and rupture and communicate with the urinary tract, the lymph fluid enters the urinary tract to form chyluria, and the varicose lymphatics can penetrate into the renal pelvis. The renal pelvis, ureter and bladder, but most penetrate the renal pelvis.
4. Kidney hydatid disease
Kidney hydatid sac is mostly single, the mother sac contains ascus and sun sac, the lesion is often unilateral, mostly in the lower pole of the kidney, round, insidious onset, the disease can reach several years or decades, cyst enlargement Large, oppressing the surrounding glomeruli, causing it to shrink and rupture, occasionally cysts penetrate into the renal pelvis or abdominal cavity, piercing into the abdominal cavity can cause urticaria, asthma, fever and abdominal pain and other allergic symptoms, severe cases can occur anaphylactic shock, if The cyst penetrates into the renal pelvis, the renal pelvis, and the cystic fluid enters the bladder. Hematuria and bladder irritation may occur. The cyst fragments may enter the ureter and cause renal colic. The signs are mainly cystic masses in the renal area. When you feel the earthquake, it is "hydatid tremor", which can be differentiated from hydronephrosis and renal cyst. The disease is complicated with hepatic hydatidosis and eosinophilia. X-ray shows round calcification in the kidney. Nuclide B-ultrasound or CT showed renal space-occupying lesions, the intradermal test of the hydatid (90% positive rate) and the complement fixation test (positive rate 80%) contributed to the diagnosis of echinococcosis.
Examine
Parasitic urinary tract infection check
Regular renal ultrasound, radionuclide, X-ray or CT examination.
Urinary tract amoebiasis
Ultrasound, radionuclide, X-ray or CT examination of the renal area contributes to the diagnosis of amoebic renal abscess or perirenal abscess.
2. Kidney hydatid echinococcosis is complicated with hepatic hydatid disease. X-ray shows circular calcification in the renal area. Radionuclide, B-ultrasound or CT indicates renal occupying lesions, which is helpful for the diagnosis of echinococcosis.
Diagnosis
Diagnosis and identification of parasitic urinary tract infection
Diagnostic criteria
Trichomonas urinary tract infection
After the first urination in the morning, there was a small amount of purulent secretion, and the urethral secretion was found to be trichomoniasis. The positive rate was up to 80%, the positive rate of urinary sediment was low, and the urine culture was negative.
2. Urinary tract amoebiasis
Fresh urine should be taken repeatedly for amoebic examination, but there is very little chance of finding amoeba from the urine.
3. Urinary filariasis
Visible chyluria, urinary sputum can be divided into 3 layers after standing: the upper layer is white fat, the middle layer is clear liquid, the lower layer is red precipitate, and the chyle urine is shaken with diethyl ether to make the urine clarify if it is in the epidemic area of filariasis If the urine is found to be milky white, contains red blood cells, white blood cells and fat, it is divided into 3 layers, and the chyle test is positive, indicating that the lesion has invaded the urinary tract, such as microfilaria (blood collection at night) and stigma found in the blood. The limb can establish a diagnosis of filariasis.
4. Kidney hydatid disease
There may be eosinophils and the like.
