Pyelocystitis (acute, chronic, candidiasis): ICD 10 code, symptoms, treatment, causes, diagnosis, complications

Causes

The cause of cystitis is infection (staphylococci, streptococci, mycoplasmas, chlamydia, viruses).

There are three reasons for the spread and entry of infection into the bladder:

1. Infection from the external genitalia. When urinating, urine enters the vagina, which subsequently leads to vaginitis, vulvovaginitis. The infection then spreads along the ascending tract to the bladder, and infectious cystitis develops. This happens more often in children aged 1.5-2 years, since estrogens in children are in small quantities, and they protect the external genitalia from infections. Pyelitis also occurs in an ascending manner when infection spreads from the bladder to the kidney (renal pelvis). This occurs when the ureteral closing apparatus is insufficient and reflux develops. This often happens in young people, when the infected flora of the bladder, due to a violation of the ureteral valve closure, enters the ureter, further into the kidney with the development of pyelitis or pyelonephritis (inflammation of the kidney). Inflammation of the kidney occurs with untreated cystitis or poor therapy.

Infection entering the bladder from the kidney. This spread of infection (downward) is less common than upward. With untreated pyelonephritis, pyonephrosis, when during an exacerbation bacteria appear in the urine (bacteriuria), inflammation of the mucous membrane of the bladder develops (cystitis).

2. Infection through the lymphogenous, hematogenous route. In women, cystitis more often occurs due to inflammatory diseases of the female genital organs: endometritis (inflammation of the endometrium of the uterus), parametritis (inflammation of the parametrium), salpingo-oophoritis (inflammation of the fallopian tube, ovaries). Therefore, it is important to identify and treat gynecological problems in a timely manner so that cystitis does not subsequently develop, which, if left untreated, will quickly develop into chronic.
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You should also ask the patient about infectious foci (bronchitis, tonsillitis, ulcers), about recent operations to open ulcers in the abdominal cavity, as well as the pelvis (prostate abscess, appendiceal infiltrate).

If not treated correctly, this can lead to the development of cystitis. That is, the infection spreads from the organs through the circulatory system, leading to the development of inflammation of the bladder.

The inflammatory process in the bladder does not occur only if there is an infection in it.

The mucous membrane of the bladder is stable and easily copes with bacteria and viruses, but when predisposing factors are added to the infection, this is more difficult to do.

Predisposing factors for the development of cystitis:

• circulatory disorders of the bladder and pelvis;
• obstruction of urine outflow (urethral stricture). This can also include urolithiasis, tumors of the ureter, which obstruct the outflow of urine, leading to inflammation of the renal pelvis (pyelitis), the kidney.
• decreased body resistance (vitaminosis, overwork, hypothermia);
• developmental anomalies of the genitourinary area.

The development of pyelitis includes the same reasons as cystitis (lymphogenous, hematogenous, ascending spread of infection).

Women are more likely to develop cystitis than men, since there are anatomical differences in the structure of the genitourinary tract in women.

In females, the urethra is shorter, wider and thicker, and is located closer to the anus, which contributes to frequent infections of the urethra.

In men, cystitis occurs when there is inflammation of the prostate gland, seminal vesicles, testicles, and urethra.

Consequences and complications

Pyelocystitis is a disease that enslaves several organs, and therefore it has multiple consequences. If pyelocystitis is not treated, it can go into a chronic stage and remind itself every time there is hypothermia or a weakening of the body’s immune system. That is, the chronic stage is very difficult to cure, and sometimes, when the disease is seriously advanced, it is almost impossible. This option involves inevitable complications:

• Kidney failure.
• Purulent inflammation in the area of ​​fatty tissue of the kidneys (abscess)
• Urolithiasis.
• Development of pathology of the urinary system.
• Oncological disease.

It should be understood that every untreated disease carries with it unpleasant consequences, however, it is precisely such consequences for the body that are unbearable torture. Timely contact with the right specialist makes it possible to avoid unwanted complications and the development of new parallel diseases.

Complaints

With inflammation of the bladder and renal pelvis, complaints arise in a complex.

• cutting, pain at the end of urination;
• frequent urge to urinate;
• cloudy urine;
• unpleasant odor of urine;
• weakness.

• lower back pain;
• cloudy urine (presence of protein, leukocytes in the urine). This indicates poor kidney function, inflammation);
• intoxication (weakness, fever, chills);
• pain when tapping in the kidney area.

Chronic pyelitis

Chronic pyelitis is a chronic inflammation of the renal pelvis.

Etiology, pathogenesis. The disease occurs as a result of untreated acute pyelitis. In most cases, it is accompanied by the appearance of inflammatory foci in the interstitium of the kidneys, i.e., chronic pyelonephritis (see).

Symptoms, course . The onset of the disease is acute pyelitis. Sometimes the onset of the disease is latent. The course of the disease can also be latent for a long time. Sometimes exacerbations are followed by a long period of attenuation. The clinical picture of exacerbations approaches the picture of acute pyelitis. Latent periods are manifested only by moderate leukocyturien or mild pain in the lower back. Sometimes there is no urinary syndrome. Pyelography can reveal changes in the shape of the pelvis and calyces. Pyelitis contributes to the development of pyelonephritis, kidney stones and, in rare cases, pyonephrosis.

Recognition is based on anamnestic data, mainly on the results of a urine test, a positive Pasternatsky symptom, more or less severe dysuria, and urological examination data. Differential diagnosis with kidney stones and other urological diseases is achieved using plain and contrast radiography, as well as based on the results of a urine test.

For treatment during periods of exacerbation, see Acute pyelitis. During periods of subsidence, a gentle diet excluding spicy seasonings and salty dishes. If even moderate leukocyturia occurs (without accompanying clinical manifestations), repeat courses of antibiotic and chemotherapy treatment lasting 3 weeks at intervals of 1-3 months. Spa treatment is also recommended (Zheleznovodsk, Truskavets).

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Treatment

1. The main thing in treating a disease is eliminating the cause. If the cause of cystitis or pyelitis is found out, then the first thing they do is eliminate the problem. In case of urolithiasis, it is better to undergo surgery to create an outflow for urine, then pyelitis will begin to subside with antibacterial therapy.
2. Eliminate spicy and highly salty foods from your diet. Drinking is important for diuresis, removing bacteria from the urinary tract. You should drink at least 2 liters of fluid per day.
3. Antibacterial therapy. The most commonly used drugs are nitrofuran drugs “Furazidin”, fluoroquinolones “Ciprofloxacin”, sulfonamides “Urosulfan”, they cope with the infection within 3-4 days.
4. Antispasmodics: “No-shpa”, “Drotaverine” relieves spasms and pain.

Nutrition

During treatment of pyelocystitis, the patient will have to follow a diet. In nutrition you must adhere to the following rules:

1. Reduce the amount of salt you consume or completely eliminate it.
2. Ensure an optimal drinking regime (at least 2.5 liters of compotes, fruit drinks, plain water per day).
3. Eat often, but in small portions.
4. Include dairy products in your diet.

It is worth giving up chocolate, smoked and fatty foods and dishes containing active essential oils. Garlic, radishes, and spices are prohibited. You should not drink strong black tea, coffee, or carbonated drinks.

What is pyelocystitis?

The urinary system is often exposed to various infectious diseases. In this article we will focus on the causes and manifestations of pyelocystitis.

Pyelocystitis is an inflammatory disease that affects the renal pelvis and bladder and occurs in candidal, chronic or acute form. The type of progressive disease depends on the type of harmful microbes that infect the body and the degree of tissue damage.

Clinical manifestations

There can be many signs of pathology, since both the kidney and bladder are affected. Treatment should be aimed at getting rid of inflammation. Clinical signs can be not only external, but also visualized in test results. Their severity is determined by the stage of the disease.

7 main signs:

1. Regular headaches.
2. Profuse sweating.
3. Hyperthermia.
4. Fatigue.
5. Loss of body weight for no apparent reason.
6. Disturbances in appetite.
7. Dizziness.

Pain appears in the lower back. They can be triggered by an inflammatory process in the kidney and bladder. Sometimes the pain radiates to the groin area. There is also pain when urinating, sometimes the urine turns red and has an unpleasant odor.

If pyelocystitis develops in a child, this is accompanied by a low amount of urine excreted, drying out of the mucous membranes, and diarrhea. It is very important to visit a specialist on time, take the prescribed urine tests, and start treatment.

Causes of pyelocystitis

The development of pyelocystitis, which in most cases is observed in women, can be caused by:

• Exacerbation or insufficiently thorough treatment of cystitis.
• Entry of infectious agents from the external genitalia and other organs affected by infections.
• Hypothermia.
• Decreased immunity.
• Vitamin deficiency.
• Regular emotional overload.
• Injuries received.
• Hormonal imbalance.
• Having promiscuous sex life.
• Anatomical abnormalities of the urinary system.
• Poor circulation of the pelvis and bladder.
• Tumor processes affecting the ureter.
• Complications of urolithiasis.
• Congestion in the urinary tract.
• Violation of personal hygiene rules.
• Insufficiently developed ability of the pelvis to push out urine (typical for newborns).

Methods of therapy

Pyelocystitis can be effectively treated only under the strict supervision of a doctor or directly in a hospital. Self-medication in this case is strictly contraindicated.

Therapy begins only after the cause of the pathology has been established. Treatment should be such that these problems are eliminated.

An antibacterial course is prescribed after determining the strain of the virus and its resistance to antibiotics. Having clarified these points, the doctor prescribes pharmacological drugs.

Traditional approach

Treatment of pyelocystitis is carried out using complex therapy consisting of several groups of drugs.

Ofloxin, Lomefloxacin, Moxifloxacin or Norfloxacin are prescribed as antibiotics.

The therapeutic effect of antibiotics is aimed at destroying microorganisms that cause the disease.

The doctor prescribes a treatment regimen based on the complexity of the infection, its location and the severity of the disease.

The standard dosage for adults is no more than 800 mg per day, which should be divided into two doses.

Children are recommended to take up to 15 mg per kilogram of weight. The tablets are taken whole during meals.

Antimicrobial drugs are also used - Sulfalen, Furazolin, Furadonin. Antimicrobial drugs are effective against pathogenic cocci, which can also cause inflammatory processes in the genitourinary system.

They are quickly absorbed by the mucous membranes, their maximum concentration is reached 4-6 hours after administration. Due to the slow removal from the body, the duration of action of the drugs increases.

In the acute form of pyelocystitis, the patient needs to take 1 g once on the first day, and 200 mg in the following days. The course lasts up to 10 days.

For the treatment of the chronic form and for prevention, 2 g per week is prescribed, which must be taken at a time. With favorable tolerance, the course lasts about 1.5 months. The tablets should be taken half an hour before meals.

To stabilize urination, herbal remedies based on medicinal herbs are prescribed - Phytosilin and Urocholum. These are pastes and drops that help wash sand out of the urinary organs and relieve pain.

Take them orally before meals, diluted 3 times a day. Dosage of Urocholum – 10-20 drops, Phytosilin – 1 teaspoon per 100 ml of water.

Painkillers

For pain relief, drugs such as No-shpa, Tempalgin, Drotaverine, Ketonal and others are used.

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Your doctor may approve the use of herbs as an adjunct to drug therapy. They use decoctions of bear ears, dill seeds, bearberry, juniper, barberry, horsetail and others.

If the diagnosis revealed, for example, stones, then the patient is indicated for surgical intervention.

Symptoms of pyelocystitis

Progressive pyelocystitis is accompanied by:

1. Unpleasant odor of urine.
2. Darkening, cloudiness of urine (a sign of increased levels of leukocytes and protein in the urine).
3. Feeling of bladder fullness, frequent urge to urinate.
4. Pain in the lower back, especially when tapping in the kidney area (pain can spread to the groin area).
5. Discomfort, pain, pain at the end of urination.
6. General malaise.
7. Increased sweating.
8. Dizziness, headache.
9. Chills, increased body temperature.
10. Decreased appetite.
11. Loss of body weight.
12. Lethargy.
13. Increased stool frequency, decreased amount of urine excreted, dry skin and mucous membranes, convulsions, recessed fontanel (these symptoms are observed in infants).

Diagnostics

In order to make an accurate diagnosis, doctors often resort to various methods of diagnosing the disease. This helps to take a broad look at the problem and prescribe the most appropriate, and most importantly, effective treatment.

Diagnosis of pyelocystitis is carried out in the following ways:

• A thorough examination of the patient to see the overall picture of the disease.
• A blood test is taken to identify the inflammatory process in the body.
• A urine test is taken to determine the number of white blood cells and proteins.
• A cystoscopy is performed to directly examine the bladder.
• Contrast uropyelography is performed to assess the quality of urine outflow.
• An ultrasound examination of the kidneys is performed to determine any changes in the kidneys.
• An ultrasound examination of the bladder is performed to examine changes in the bladder and tissues.
• An MRI is done to examine the functioning of internal organs and tissues.
• A biopsy of the lining of the bladder is taken to determine the presence of cancer cells.

Bladder biopsy

Diagnostic methods enable doctors to fully determine the degree of development of the disease and select a therapy that will help not only cure the pathology, but also not harm other organs of the entire body system.

Treatment methods

Therapy for the disease is aimed at identifying and eliminating the factors that provoked its development.

The prescription of a treatment course is preceded by a diagnosis that allows one to determine the type of bacteria that causes pyelocystitis. Along with laboratory tests, specialized specialists use instrumental examination methods.

Treatment of the disease includes:

• Use of antibiotic drugs prescribed by a doctor (during therapy, urosulfan, furazidin, ciprofloxacin, drotaverine, no-spa and other drugs are used).
• The use of anti-inflammatory, diuretic complexes, including drugs with medicinal herbs.
• Use of painkillers.
• Diet therapy (refusal of spicy, smoked, fried foods containing a large amount of salt, alcoholic beverages, foods with a high calcium content).
• Increasing the volume of clean water consumption: more than 2 liters daily (this helps to accelerate the elimination of bacteria in the urine).
• Regular consumption of dairy products and natural products of plant origin.
• Limiting physical activity, maintaining sexual rest, bed rest, and personal hygiene rules. When washing, it is advisable to use special intimate hygiene products with an antibacterial effect, which will reduce the risk of new infections entering the urethra.
• Refusal to take warm baths, visit saunas and baths.
• Carrying out surgical operations (in particular, for anatomical anomalies).

Ignoring the manifesting symptoms of acute pyelocystitis and not taking prescribed therapy seriously can provoke the development of chronic pyelocystitis with complications.

Acute form

Pyelocystitis in the acute form has clear symptoms, while the chronic form has more subtle symptoms. Often this disease occurs in childhood, when the treatment is incorrect, the process becomes chronic, and periodic strong inflammatory processes appear - periods of exacerbation, a period of calm - remission.

During an exacerbation, all signs intensify several times, bringing the patient to the hospital. Treatment is necessary for both forms, only in case of a chronic course it is rather preventive in order to prevent the condition from worsening. Competent treatment and compliance by the patient with the prescribed rules can provide him with a long period of remission, which will make it seem that the disease has been defeated. Diagnostics are needed to confirm that there will be no more exacerbations.

Treatment should begin with following a daily routine and diet.

Excluded from the diet:

1. smoked dishes;
2. salty;
3. alcoholic drinks;
4. fried food;
5. spices;
6. foods rich in phosphates and calcium.

Include in your diet:

1. consumption of large amounts of clean water;
2. plant food;
3. milk products.

• Maintain personal hygiene - prevent infections from entering the genitals and urethra; Carry out hygienic procedures with special means.
• Wear loose cotton underwear that does not restrict movement.
• Avoid sexual intercourse; if it occurs, toilet the genitals.
• Treatment includes bed rest and reducing physical activity on the body.
• It is allowed to warm the bladder area with dry heat, but it is better to avoid taking baths and saunas, as they contribute to a new infection.
• Antibacterial therapy is necessary, but it is better to start treatment with drugs after identifying the infectious agent. Bacteria are sown on nutrient media, their increased sensitivity to antibiotics is determined, and the drug is prescribed in accordance with these data. Before the results of the study, medications are used that affect many groups of bacteria, and in urology fluoroquinolones are more often used:

1. "Ofloxacin";
2. "Norfloxacin";
3. "Lomefloxacin";
4. "Moxifloxacin."

• Pain syndrome is treated with antispasmodics and painkillers:

1. "No-shpa";
2. "Drotaverine";
3. "Buskopatn";
4. natural antispasmodics, for example: chamomile, oregano, mint;
5. "Analgin";
6. "Ketonal";
7. "Took";
8. "Tempalgin".

• Antimicrobial drugs – sulfonamides:

1. "Urosulfan";
2. "Sulfalen";
3. "Sulfadimethoxine".

• Antimicrobial agents – nitrofurans:

1. "Furazolin";
2. "Furadonin";
3. "Levomecitin".

• Complex preparations combining antimicrobial, anti-inflammatory, antispasmodic, and diuretic properties. The preparations are based on herbs that have these properties.

1. "Phytolysin";
2. "Urocholum".

• Herbal decoctions and infusions are used in folk medicine. Do not forget that without drug therapy they cannot help:

1. horsetail;
2. millet;
3. bear ears;
4. Dill seeds;
5. juniper;
6. flax seeds;
7. Linden;
8. bearberry;
9. barberry.

• Anomalies in the development of the urinary system require surgery.

Pyelocystitis is a very serious disease that can haunt the patient for the rest of his life, so take therapy seriously and try to complete the course prescribed by your doctor!

What should be the diet for cystitis - this will be discussed below:

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Prevention

Reducing the risk of developing pyelocystitis is achieved by:

1. Avoiding overloads.
2. Providing the body with enough rest (daily sleep).
3. Optimizing your diet.
4. Maintain personal hygiene.
5. Using cotton underwear (to avoid diaper rash, which helps create an environment favorable for the growth of bacteria and fungi).
6. Therapy for detected diseases of the bladder and kidneys.
7. Strengthening the immune system.
8. Maintaining normal hormonal levels.
9. Avoiding unprotected sex.

How does acute and chronic pyelocystitis manifest, how to treat?

Most often, the cause of this serious disease is untreated cystitis or its exacerbation. Infection occurs in the kidneys and bladder with the outflow of blood or lymph.

When urine stagnates, inflammation appears in the bladder, leading to pyelocystitis. Quite often, stagnation of urine is observed in infants, since the pelvis is still poorly emptied. Moreover, girls suffer from this disease much more often than boys, this is due to the structural features of the genitourinary organs. A short urethra makes it easy for germs to enter the genitourinary system.

Hormonal imbalances in the female body lead to pyelocystitis. The cause of the disease can be a weakened immune system, hypothermia, stress and anxiety, and injury. Pyelocystitis can develop due to neglect of intimate hygiene and unprotected sexual intercourse.

Why does the disease occur?

The development of the disease is accompanied by damage to two internal organs at once:

• Kidneys;
• Bladder.

Therefore, provoking factors may be different. Initially, the disease develops as a result of acute or incompletely cured cystitis. Infectious agents penetrate the internal organs, begin to multiply and cause an inflammatory process.

The risk of developing the disease increases with the presence of kidney stones and with frequent relapses of cystitis. With prolonged stagnation of urine, an inflammatory process begins to develop, which provokes pyelocystitis. That is why it is very important to consult a doctor promptly and undergo treatment.

Often a newborn baby may have pyelocystitis. This is due to the inability of the pelvis to push out urine in the first few days after birth. Urine stagnation occurs, inflammation develops, and there may be pain and other symptoms of the disease. It is important to visit a doctor as early as possible and begin treatment.

More often, pyelocystitis occurs in females. This is due to the anatomical features of the genitourinary system, since a woman’s urethra is shorter, it is easier for bacteria to penetrate into the bladder and subsequently into the renal pelvis. If there are disturbances in the hormonal environment, there is a danger of developing the disease. The main causes of the disease include:

1. Weakened immune system.
2. Hypothermia of the body.
3. Regular emotional stress.
4. Leading a disorderly intimate life.
5. Lack of a full-fledged personal toilet.

Important! It is recommended to monitor your health status and consult a doctor promptly if you experience pain, stagnation of urine or other symptoms. The doctor will order tests, find out whether there is a problem with stagnation of urine, and prescribe appropriate treatment.

Symptoms of pyelocystitis

Due to the fact that the disease occurs in two organs, there are many symptoms. The number of symptoms and the severity with which they appear will directly depend on the form of the disease. The most common symptoms:

Intoxication syndrome:

• Headache;
• Dizziness;
• Increased sweating;
• Fever and chills;
• General malaise;
• Loss of appetite and weight;
• Slow reactions.

Pain syndrome:

• Severe pain in the lumbar region, which can radiate to the groin;
• Pain and burning when urinating;
• If you lightly tap on the kidney area, you will feel pain.

Proteinuria:
When taking a urine test, protein is detected, which indicates a violation of the kidneys.

The presence of leukocytes in urine analysis.

Caused by an admixture of pus.

Dyspeptic disorder (in infants):

• Abdominal pain;
• Increased bowel movements.

Dehydration (in infants):

• Dry skin and mucous membranes;
• Decreased amount of urine;
• Recession of the fontanelle;
• Cramps.

In adults

Pyelocystitis in an adult can be primary or secondary. The primary form of the disease develops after adnexitis, cystitis or prostatitis. Inflammation of the kidneys occurs with sinusitis, bronchitis, tonsillitis and cholecystitis.

External signs of pyelocystitis in women and men include pain in the lower back and hips, cloudy urine with an unpleasant odor, colic and tension in the abdominal walls.

Infection of a newborn child occurs from the mother when the pathogen enters the child’s body through the blood or lymph. Pyelonephritis most often affects infant boys. And after a year, the disease more often affects girls.

With pyelocystitis, the child loses his appetite.

Children with pyelocystitis suffer from general intoxication of the body, increased temperature; loss of appetite, vomiting and bloating. The child cries, is capricious and becomes inactive and lethargic.

Symptoms for adults and children are almost the same; they depend on the form and stage of pyelitis.

Stages of flow

It is worth noting that there are no characteristic symptoms; it is often confused with other urological diseases. The most striking symptom is considered to be lower back pain. The acute form is characterized by the following symptoms:

• increase in body temperature up to 39 degrees;
• increased sweating, chills at night;
• pain in the head and lumbar region;
• decreased number of urinations;
• changes in urine color;
• loss of appetite;
• vomit;
• general deterioration of condition;

Children with acute pyelitis are characterized by frequent urination and cloudy urine (due to traces of purulent discharge). This condition lasts from 7 to 21 days. At the same time, the child eats and sleeps poorly and becomes very capricious.

Sometimes such symptoms are mistaken for a manifestation of cystitis and incorrect treatment is started, so consultation with a specialist who will help make the correct diagnosis is very important.

In the chronic form, all the signs of the acute stage are accompanied by pallor of the skin and a coating on the tongue. A characteristic feature during this period is the variable appearance and disappearance of unpleasant sensations.

If both kidneys are infected, the symptoms will increase significantly, and the patient will experience discomfort when passing urine. In order to determine the form of the disease, it is necessary to undergo a series of studies.

Pyelocystitis and its varieties

In the acute form of the disease, symptoms manifest themselves clearly and unexpectedly. Acute pyelocystitis is characterized by severe pain, which can also intensify. Acute pyelocystitis is treated in a hospital, carrying out a more in-depth diagnosis to prescribe effective therapy.

If we compare the acute form and the chronic form, then in the second case, unlike the first, the symptoms of the disease are more blurred. Some of the obvious symptoms of the disease may not appear. Chronic pyelocystitis worsens with slight hypothermia or with the slightest decrease in immunity. It is this form of the disease that is more difficult to treat than others.

Candidiasis type of pyelocystitis.

This type of pyelocystitis occurs when fungi of the genus Candida enter the bladder and renal pelvis and is an exacerbation of thrush. It can appear in both women and men.

Classification

Pyelocystitis can be acute, chronic and candidal. When the acute form develops, the symptoms are pronounced and appear suddenly, within a few days.

The chronic form of pyelocystitis can occur due to improper treatment of the acute form. The symptoms are not clearly expressed; kidney inflammation is often manifested in the test results.

When fungi penetrate the genitourinary system, the candidal form of pyelocystitis develops. Treatment is complex, aimed at eliminating the causative agent of the disease.