Kidney abscess
Introduction
Introduction to renal abscess Renal abscess (renalabscess) renal abscess refers to the destruction of the renal parenchyma due to inflammation and purulence, the formation of a purulent cyst, complete loss of renal function, common in patients with upper urinary tract obstruction. It is usually due to the continued development of acute pyelonephritis and the formation of necrosis. Diagnosis relies mainly on abdominal ultrasound and CT. Pay attention to foods that are easy to digest, rich in calories and vitamins. basic knowledge The proportion of illness: 0.005%-0.008% Susceptible people: no special people Mode of infection: non-infectious Complications: acute pyelonephritis, urinary tract obstruction, perirenal abscess, kidney injury, perirenal inflammation, urinary tract infection
Cause
Cause of renal abscess
Secondary infection of acute pyelonephritis (35%):
Renal abscesses are usually due to the continued development of acute pyelonephritis, necrosis and the formation of a cavity containing pus. Diabetes and infectious stones are often a potential cause of kidney abscess.
Secondary infection of renal cysts (26%):
Occasionally a secondary infection of the renal cyst can also form a renal abscess. Subcapsular abscess can develop into a perirenal abscess, whereas kidney abscesses are less likely to exist alone than perirenal abscesses.
Pathogenic bacteria infection (25%):
The pathogen is usually a Gram-negative bacillus. Staphylococcus aureus renal abscess can be secondary to staphylococcal sepsis caused by infection at other sites.
Prevention
Kidney abscess prevention
The treatment of renal abscess is not timely. The pus can penetrate the renal capsule to form a peri-renal abscess or urinary sepsis. At the same time, a sufficient amount of antibiotics should be used. If the kidney can still be retained, the cause should be relieved first: if the obstructed stone is removed, or the complex is removed. Ureteral malformation, renal stoma, drainage of pus, preservation of renal function, relief of symptoms, severe renal damage, severe loss of function, nephrectomy.
Complication
Kidney abscess complications Complications acute pyelonephritis urinary tract obstruction perirenal abscess kidney injury peri-renal inflammation urinary tract infection
Acute pyelonephritis, urinary tract obstruction, perirenal abscess, kidney damage, perirenal inflammation, urinary tract infection.
Symptom
Symptoms of renal abscess Common symptoms Urinary frequency with urgency and dysuria Low back pain with kidney area sputum pain, hot chill, stomach area, block, hematuria, fever
1. Fever: Sudden chills, high fever, body temperature rises above 39 °C, accompanied by headache, systemic pain, and nausea and vomiting. The heat type is similar to sepsis. After sweating, the body temperature drops, and then it can rise again for about 1 week.
2. Low back pain: unilateral or bilateral low back pain. There is obvious tenderness in the kidney area and rib pain in the ribs.
3. Bladder irritation: urinary frequency, urgency, dysuria, hematuria, and systemic symptoms appear after acute pyelonephritis caused by ascending infection. People with blood infections often start with high fever, and bladder irritation symptoms appear later. Sometimes it is not obvious.
Examine
Examination of renal abscess
There are typical clinical manifestations. Urine examination includes white blood cells, red blood cells, proteins, casts and bacteria. The urine bacteria culture has more than 100,000 colonies per milliliter of urine, and the white blood cell count is increased. Neutrophil enlargement is obvious, and it is not difficult to determine the diagnosis. Clinically, acute pyelonephritis is often accompanied by cystitis, and lower urinary tract infection can cause ascending infection involving the kidney, sometimes difficult to distinguish. However, lower urinary tract infection is mainly characterized by bladder irritation. And often have lower abdominal discomfort, soreness, and rarely have systemic symptoms such as chills and fever. After the acute phase symptoms control, the patient should be further examined to find out whether there are anatomical abnormalities such as urinary tract obstruction and vesicoureteral reflux for further treatment.
Diagnosis
Diagnosis and identification of renal abscess
Diagnostic points:
1. Fever, low back pain, kidney block.
2. A large number of pus cells in the urine.
3. The white blood cells in the blood are significantly increased.
4. X-ray plain film is enlarged, and the kidney is not developed after angiography.
Imaging features
Diagnosis relies mainly on abdominal ultrasound and CT. The boundary of the acute abscess is unclear, but its echo is also significantly stronger than other parts. After the infection is limited, the ultrasound shows a round hypoechoic mass with irregular wall thickness, internal echoes with uneven echoes, and uneven internal density. After the enhancement, the wall of the abscess can be characterized as irregular enhancement, unless the gas in the abscess contains gas. In this case, it is more difficult to distinguish the necrosis from the tumor. Arterial angiography can detect a small blood vessel mass, the boundary is unclear, and the kidney blood vessels are replaced. Although there is no typical tumor vascular manifestation, inflammatory neovascularization can occur, which is difficult to distinguish from tumors. Gallium scans can be used to identify abscesses and tumors, but because lymphomas can show increased gallium absorption, they cannot be distinguished from abscesses. With the extent and extent of lesions, different degrees of renal shadow enlargement, renal pelvis distortion and renal secretion function may occur in intravenous pyelography.
