Urinary tract fungal infection
Introduction
Introduction to urinary tract fungal infection Refers to the urinary tract inflammation caused by the pathogen invading the urinary tract mucosa or tissue. Fungal urinary tract infection, various pathogenic fungi infection urinary tract, more common in women of childbearing age, pay attention to the cleanliness of the vulva is very important. According to the site of infection, urinary tract infections can be divided into upper urinary tract infections and lower urinary tract infections. The former is pyelonephritis, and the latter is mainly cystitis. Urinary tract infections can also be classified into complex urinary tract and non-complex urinary sensations depending on the presence or absence of underlying disease. basic knowledge The proportion of illness: 0.08% Susceptible people: more common in women of childbearing age Mode of infection: non-infectious Complications: pyelonephritis cystitis
Cause
Causes of urinary tract fungal infection
Candida (45%):
Urinary tract fungal infections primarily affect the bladder and kidneys. The most common cause is the Candida species, which are normal symbiotic bacteria of humans and are often found in the mouth, gastrointestinal tract, vagina and damaged skin. However, all pathogenic fungi (such as Cryptococcus neoformans, Aspergillus species, Mucor species, Histoplasma, Bacillus, Coccidioides) can infect the kidney as part of a systemic or disseminated fungal infection.
Bacterial and antibiotic treatment (17%):
Candida urinary tract infections are mainly due to local urinary tract catheters. In general, although Candida and bacterial infections often occur simultaneously, most Foley catheters are associated with fungal infections following bacteriuria and antibiotic treatment.
Nosocomial infections (15%):
Renal candidiasis is usually a blood-borne dissemination, often originating from the gastrointestinal tract, from the ascending infection of the renal ostomy, other long-term indwelling, stents will also occur. High-risk patients are those with cancer, AIDS, chemotherapy or Immunity-impaired patients with immunosuppressive drugs. The main source of nosocomial infection in canine bacteremia in this type of patients is intravascular indwelling catheters. Kidney transplantation increases the risk of fungal infections because of indwelling catheters, stents, Antibiotics, anastomotic leakage, obstruction and immunosuppressive therapy.
Prevention
Urinary tract fungal infection prevention
Fungal urinary tract infections are more common in women of childbearing age. It is important to pay attention to the cleanliness of the vulva. There are certain incentives for urinary tract infections. Therefore, patients should be carefully examined for urinary calculi, kidney or ureter with or without deformity, etc. In addition to treatment, drink plenty of water, keep the daily urine volume above 2000ml, which plays a role in urinary tract irrigation. It is also very important for the treatment of urinary tract infections. The application of traditional Chinese medicine to treat urinary tract infections has accumulated a lot of clinical experience. Applications such as heat-clearing and detoxifying Banlangen, Dingding, Sauce, and plantain, in addition, should also pay attention to strengthen nutrition and enhance physical fitness.
Complication
Urinary tract fungal infection complications Complications, pyelonephritis, cystitis
Frequent pyelonephritis, cystitis, ureteral obstruction, renal papillary necrosis and other complications.
Pyelonephritis, also known as upper urinary tract infection, is usually associated with urinary tract inflammation. Acute pyelonephritis occurs in women of childbearing age. Patients often have low back pain, tenderness in the kidney area, sputum pain, chills, fever, headache, nausea and vomiting. Symptoms, as well as urinary urgency and urinary pain and other bladder irritation, blood tests can be seen increased white blood cells. Generally no hypertension or azotemia. The patient's urine is turbid, there may be gross hematuria, urine routine microscopic examination has a lot of white blood cells or pus cells, there may be a little red blood cells and casts, the protein is a little to moderate.
Cystitis: acute cystitis often starts suddenly, urinary tract has burning pain when urinating, frequent urination, often accompanied by urgency, severe urinary incontinence, urinary frequency urgency is often particularly obvious, up to 5 to 6 times per hour, each time The amount of urine is not much, even a few drops, and there may be pain in the lower abdomen at the end of urination. Urine turbidity, sometimes hematuria, often evident in the terminal phase. Mild tenderness in the suprapubic bladder area. Some patients have mild low back pain. When the inflammatory lesions are confined to the bladder mucosa, there is often no fever and leukocytosis in the blood. The systemic symptoms are mild and some patients have fatigue.
Ureteral obstruction: manifested as dynamic dysfunction at UPJ. It is characterized by no obvious intraluminal stenosis and extraluminal compression factors in UPJ. The ureteral catheter can pass smoothly during retrograde urography, but there is obvious hydronephrosis.
Symptom
Symptoms of urinary tract fungal infection Common symptoms No urinary frequent fever, turbid turbid sausage, pus, pee, urgency
In the case of unexplained Candida urine, timely evaluation of urinary tract structural abnormalities has been confirmed. Patients with candida urine have been clinically demonstrated as asymptomatic candidiasis, urethritis and prostatitis, cystitis (with or without Fecal stone formation or gas formation), primary renal candidiasis and blood-borne disseminated candidiasis.
Unlike bacterial urinary tract infections, Candida urine levels reflect true Candida urinary tract infections, and not only contamination of colonic colonies or urine specimens is not known, usually in the presence of cystitis or irritation and Candida Diagnosis of cystitis in high-risk patients with urine. Substance discharge from fungi can sometimes be observed, cystoscopy and kidney, and bladder ultrasound helps to detect fecal formation and obstruction.
There is fever and candida urine, sometimes there is nipple necrosis and fungal ball discharge suggesting the diagnosis of ascending renal candidiasis, although renal function is often reduced, such as severe renal failure is rare in the absence of renal obstruction. Urinary tract imaging can help evaluate Degree of involvement. Candida blood culture is often negative.
Examine
Urinary tract fungal infection check
1. The waist is tender and the kidney area is sore.
2. Urine routine examination, leukocytosis in the urine, pyuria.
3. Dyed smear of urine sediment to find bacteria.
4. Urine bacteria culture finds bacteria.
5. Urine colony count >10 5th power /ml, there are symptoms such as frequent urination, >10 2nd power /ml is also meaningful; cocci 10 10th power -10 4th power /ml also has diagnostic significance.
6. One hour urine sediment counts white blood cells > 200,000.
7. Blood routinely showed elevated white blood cells and left neutrophil nucleus.
Diagnosis
Diagnosis and identification of urinary tract fungal infection
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.
Differential diagnosis
The disease should be differentiated from urethral syndrome, renal tuberculosis, glomerular disease, prostatitis, urinary tract stones, abdominal organ inflammation.
(1) Inflammation of the abdominal organs: Some cases of urinary tract fungal infections mainly include abdominal pain, nausea, vomiting, fever, increased white blood cell count, easy misdiagnosis as acute gastroenteritis, appendicitis, annex inflammation, etc. Identification.
(2) urethral syndrome: in women with urinary tract symptoms, about 70% of patients have pyuria and bacterial urine, which is a true urinary tract infection, while another 30% of patients are not true urinary tract infections, but belong to urethra synthesis Such cases are often easily misdiagnosed as urinary tract infections in the clinic.
(3) urinary tract fungal infection should also be differentiated from kidney tuberculosis, glomerulonephritis, prostatitis and other diseases, which will be described in detail later.
