Symptoms of purulent pyelonephritis: causes, diagnosis and treatment

Basic information and causes

Depending on its origin, it is divided into:

1. Primary - the development of inflammation begins in the fiber.
2. Secondary - begins in the kidney and spreads to the fiber.

Secondary paranephritis is more common - about 80%, most often it occurs in adults 16-56 years old. As a rule, the left kidney is affected by the disease; both are extremely rare at the same time.

Paranephritis is caused by pathogens, usually staphylococcus. The primary form of the disease occurs as a result of injury to the perinephric tissue, which causes infection to enter it, and the ingress of pathogenic microorganisms from distant infectious foci is also the cause.

It occurs both immediately after trauma and some time later due to the occurrence of an inflammatory process.

The secondary form is a complication of kidney pathology - during a breakthrough, pus from the kidney enters the tissue, and the infection can also enter hematogenously or lymphogenously during pyelonephritis. The state of immunity is of great importance for the development of the disease; if it is very weak, then paranephritis becomes a consequence of pyelonephritis.

Purulent inflammation of the perinephric tissue can also develop as a consequence of the spread of infection from other internal organs.

The following conditions are considered risk factors:

• urinary excretion disorders;
• stones and sand in the kidneys;
• violation of the nervous regulation of urination;
• endocrine diseases;
• chronic sinusitis;
• tonsillitis;
• cystitis;
• cholecystitis.

Purulent escudate with paranephritis is light green, thick, and odorless.

Life forecast

Paranephritis gives an ambiguous diagnosis. How long do they live with the primary form? Fortunately, antibacterial treatments have a positive effect. However, the life prognosis is significantly worse in the secondary form. Much depends on the development of the diseases against which paranephritis developed, as well as complications that occur in case of ineffective treatment:

• Peritonitis - spread of purulent exudate to the abdominal cavity;
• Pleurisy is the transition of purulent inflammation to the pleura;
• Sepsis is the spread of infection to the intestines.

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Types and forms of the disease

The inflammatory process begins in the lymph nodes located throughout the surface of the kidney, therefore paranephritis is divided into 4 subtypes:

• front;
• rear;
• upper;
• lower;
• total - the disease affects all parts of the fiber.

Paranephritis is characterized by a one-sided course; it occurs extremely rarely in two kidneys at once.

The disease occurs in two forms: acute and chronic.

Sharp character

The acute form is characterized by the presence of a stage at which exudative inflammation occurs. It can become either reversible or continue to the next stage.

If the purulent inflammation continues to spread, this leads to melting between the fascial partitions, and as soon as the escudate reaches a large size, it begins to spread beyond the fiber and can descend into the pelvis.

Phlegmon of the retroperitoneal space can also form, which can break into the abdominal or pleural cavity, under the skin or into the bladder.

If acute paranephritis has developed in the upper segment of the kidney, it is complicated by an abscess and pus can break into the pleura and lung.

Chronic configuration

The main cause of the disease in its chronic form is the presence of inflammatory processes in the perinephric tissue over a long period of time, during which it gradually degenerates into fibrous tissue.

It can also be the outcome of an acute form of paranephritis. In rare cases, this disease occurs after kidney surgery. This form is secondary in nature.

The chronic form is characterized by the replacement of perinephric tissue with fibrous tissue.

There are two forms of chronic paranephritis: fibrous-sclerotic and fibrous-lipomatous.

Prevention

Paranephritis is an unpleasant disease. And in order to prevent it, it is necessary to avoid purulent-inflammatory processes in the organs. Thus, it is important to strengthen the immune system. To do this, you should eat right, spend as much time in the fresh air as possible, and do health-improving exercises.

It is important to protect the kidneys from hypothermia, as this is one of the reasons for the development of paranephritis. It is also worth giving up bad habits, especially alcohol.

Since paranephritis is a serious disease, its symptoms should force a person to immediately seek medical help. Timely treatment has a fairly good prognosis.

Symptoms and signs

The main symptom of paranephritis is pain in the kidney area, and it manifests itself both with complete rest and during slight palpation of the lower back.

Palpation also allows you to detect a small protrusion in the lumbar region.

In addition to pain, there are other clinical manifestations:

• increased fatigue;
• general weakness;
• shortness of breath;
• sudden weight loss.

The chronic form is characterized by a slight increase in body temperature to 37.5-37.7 oC.

Stages of flow

The clinical symptoms of paranephritis in acute form go through several stages of development. The early stage (infiltration) is manifested by the absence of pain, but there is an increased body temperature, sometimes above 39.5 oC and general malaise; it is very difficult to recognize the disease at this stage, since the clinical picture is “blurred”.

At the second stage, the patient experiences pain in the lumbar region, and it can shift to the peritoneum, thigh and even shoulder.

On the lower back, on the side of the affected organ, hyperemia and swelling of the skin occurs. It is at this stage that the patient experiences a characteristic symptom - he tries to pull his thigh towards his stomach. At this stage, the purulent infiltrate is clearly visible on palpation.

Rehabilitation period

Rehabilitation is very important to prevent relapse of the disease. When taking medications, the intestinal microflora suffers first of all. Antibiotics have a detrimental effect not only on pathogenic microorganisms, but also on beneficial bacteria. All patients who have had paranephritis are prescribed probiotics.

Then the victims are given a course of physiotherapy. The most popular methods are considered to be: ultraviolet radiation, thermal influence on the diseased area. Some patients prefer massage or mud therapy. It is important to maintain the normal functioning of a healthy kidney; a huge burden is placed on it. For these purposes, sanatorium-resort treatment is actively used.

Considering the causes of paranephritis, to prevent the disease, doctors recommend avoiding inflammation in the kidneys and stopping chronic lesions in other organs in a timely manner. Take care of a strong immune system, which includes annual holidays at seaside resorts and regular intake of vitamin courses. If necessary, the victim should visit an immunologist to determine the state of his defenses. Such trips are recommended for patients who often suffer from infectious diseases.

Kidney paranephritis is a rather serious disease that requires immediate and adequate treatment. Contact a doctor promptly and get treatment.

Who to contact and diagnostic methods

The diagnosis and treatment of paranephritis is carried out by urologists, nephrologists and surgeons.

Unfortunately, due to the absence of clear characteristic symptoms at the first stage, the patient most often turns to a therapist, and only after the manifestation of clinical symptoms the patient is transferred to a highly specialized department.

It is precisely because of the “masking” of the purulent process that it is important to carry out a correct diagnosis in a timely manner.

The most informative is a puncture of the perinephric tissue; if the disease still exists, then there will be pus in the puncture.

However, as a rule, this study is carried out after a number of basic methods, such as:

• clinical tests of urine and blood;
• bacterioscopic examination of urine sediment;
• Ultrasound;
• X-ray of the lumbar region;
• excretory urogram;
• CT;
• MRI with isotope contrast.

A clinical blood test is characterized by an increase in the level of leukocytes to 26 * 103 thousand / μl, and the ESR indicator also increases.

The importance of diet

Treatment of the disease must be accompanied by dietary adjustments. Features of the diet for paranephritis are as follows:

• exclusion of foods that increase urine formation (sour, salty, watermelon);
• organize split meals so as not to burden a healthy kidney.

Alcoholic beverages should also be avoided not only for the recovery period, but also in the future.

To achieve a complete recovery, it is important to take comprehensive measures to treat paranephritis.

Methods of therapy

In order for the treatment of paranephritis to be successful, it is important to promptly seek help from a doctor and undergo therapy in a hospital setting.

To treat chronic paranephritis in the latent phase, conservative treatment is carried out.

The course of treatment is supplemented with absorbable procedures; if the effect of therapeutic methods is not observed, then surgical intervention is performed. To prevent relapse, the patient is prescribed glycocorticoids and lidase.

Traditional methods

At the infiltration stage, the disease is effectively treated with antibacterial drugs, usually of the cephalosporin group (Cifran, Terzef, etc.) or sulfonamides, carbapenems and fluoroquinols; in each specific case, the drug is selected individually.

In order to relieve pain and relieve muscle spasms, UHF or local warming can be used.

Additionally, the patient is prescribed drugs for detoxification, restoratives, biogenic stimulants, uroseptics, and, if necessary, a blood transfusion is performed.

Surgical intervention

If the disease is in acute form and an abscess is present, then surgical intervention is mandatory - lumbotomy and opening of the abscess.

During lumbotomy, the abscess is opened through the retroperitoneal space and drained into its cavity, and purulent cavities are also inspected.

If paranephritis is caused by apostematous nephritis, the kidney is decapsulated; if there is a carbuncle, then it is dissected.

During the postoperative period, the patient also needs to take antibiotics. In very advanced cases, it is even possible to remove the kidney.

ethnoscience

Despite the fact that traditional medicine is effective for the treatment of many kidney diseases, in the case of paranephritis they should absolutely not be used. This is due to the following factors:

• medicinal plants do not have such a strong antibacterial and anti-inflammatory effect necessary for this pathology;
• If you use local warming compresses, this will only worsen the problem.

Therefore, at the slightest suspicion of kidney disease, you should consult a doctor and not engage in traditional self-medication.

Treatment

Therapy for purulent pyelonephritis is carried out in a hospital and includes conservative treatment and surgical treatment (in severe cases).

Here we can no longer do without antibiotics. We urgently need to get rid of the suppuration. Therefore, the doctor carefully selects several options for antibiotic therapy , which will be most effective in this particular case. For example, the following may be assigned:

• Amoxicillin, Ampicillin;
• Cefuroxime;
• Paraxin.

Antibiotics will have to be taken for at least two weeks, and it is very important to follow the dosage determined by the doctor. Often, for this form of the disease, drugs are administered intravenously.

When 14 days have elapsed, they resort to a second regimen of antibacterial therapy. At the same time, antifungal agents are prescribed, for example, drugs based on nystatin, as well as intramuscular vitamins (B1 and B12), anti-inflammatory drugs (Diclofenac).

The patient must follow a diet that involves minimizing salt intake.

Complications

If the treatment did not start on time or was initially carried out incorrectly, this can lead to serious complications.

As a result of untreated paranephritis, hematogenous generalization may occur, in which case pus from the affected organ enters the blood vessels and spreads throughout the body.

This leads to an exacerbation of existing symptoms and the possible appearance of ulcers in other organs and systems; in this situation, the following may develop:

• peritonitis;
• pionthorax;
• sepsis;
• renal fistula;
• breakthrough of pus into the bladder.

Such unfavorable complications now occur extremely rarely, thanks to the high level of diagnosis and treatment with antibacterial drugs.

Surgery

Surgery is resorted to in cases where conservative therapy does not give the desired results, as well as if doctors diagnose a carbuncle , or when there is too much pus. Specialists try to remove only the affected area, preserving the kidney as much as possible.

After the operation, the efforts of doctors are aimed at preventing the spread of microbes in the body , at restoring the patient and eliminating intoxication. For this purpose, broad-spectrum antibiotics, glucose, and drugs to maintain the activity of the heart and blood vessels are prescribed.

Preventive measures

The best preventive measures to prevent the occurrence of paranephritis is to prevent the occurrence of inflammatory diseases of the genitourinary system.

To do this, it is necessary to maintain a normal level of the immune system - get more rest, eat right and, if necessary, take vitamins.

If there is a history of any kidney disease, then annual preventive examinations with a urologist or nephrologist would be appropriate.

After proper treatment of paranephritis, the patient quickly returns to normal life. In the future, he must avoid hypothermia, take care of personal hygiene and eat right. If you follow all the doctor’s recommendations, the chance of recurrence of paranephritis is extremely small.

In any case, after suffering such a disease, a person becomes at risk, that is, he has a predisposition to diseases of the urinary system.

Caution: pus in the kidneys!

Pyelonephritis is an infectious disease of the genitourinary system, most often affecting the renal pelvis or one of the kidneys. Sometimes it covers the entire organ.

Pyelonephritis occurs:

1. Primary. Occurs as a result of an old or hidden infection in the body: ARVI, inflammatory diseases of the urinary tract, even deep caries.
2. Secondary. Doctors call it chronic, since in the past the patient suffered from an acute stage of the pathology, which turned into purulent pyelonephritis. The most common type of this disease.

The purulent form of the disease is very insidious. It threatens human health, is difficult to treat and requires long rehabilitation of the patient. Sometimes surgery is used.

In the population, apostematous nephritis or kidney abscess occurs in 100 people per 100 thousand. The fair sex is affected more often, including approximately 6 percent of pregnant women. It occurs rarely in children, in 0.1% of cases, but in elderly people it breaks records - 50 percent.

First aid for exacerbation of paranephritis

A patient diagnosed with chronic paranephritis may sometimes experience attacks of exacerbation of the disease. Typically, such patients have a list of medications that can quickly alleviate the condition and reduce pain.

The sequence of first aid includes several stages.

1. The patient should be laid horizontally and, if possible, his movements should be limited.
2. The lumbar region must be kept warm, it is advisable to place a heating pad on the inflamed area.
3. At the first opportunity, the patient is advised to be hospitalized in the urology department, and before that - bed rest, rest, antibiotics and painkillers.

Even if the painful sensations were temporarily reduced, and after rest and rest the patient feels better, it is still necessary to see a doctor and complete comprehensive treatment. With advanced paranephritis, serious complications are possible in the form of rupture of purulent collections into the intestines, abdominal cavity or sepsis.