The symptoms and treatment of carbuncle of kidney
Carbuncle of the kidney can develop due to the thick purulent focus as a consequence of bacterial invasion. Pathology can be a primary disease, which is accompanied by formation of bacterial thrombus in the lumen of a blood vessel located in the cortex of the kidney or in the number of small blood vessels located close to each other. If one closes the lumen of the large vessel, it soon formed a massive hotbed of septic infarction, if there is a blockage of some small blood vessels, forming a number of small foci, quickly merging over time. Purulent fusion of carbuncle may lead to the spread of infectious process in the medulla of an organ or dissection of the lesion into the renal pelvis, the layers of fat tissue. The consequence of the latter complication can be the development of purulent paranephritis.
If pathology develops on the background of acute pyelonephritis, the appearance of the carbuncle becomes as a consequence of hematogenous septic thrombosis of one large blood vessel, and the result of the narrowing of its lumen due to inflammatory process (formation of infiltration).
The most common causative agent are the Golden and white Staphylococcus, and E. coli or Proteus. In 40% of cases in one patient at the same time found two diagnoses: epistemology and pyelonephritis carbuncle of the kidney.
The symptoms of carbuncle of kidneyExternally, the carbuncle of the kidney looks like a big formation rounded shape. When the autopsy is visible nekrotizirovanne fabric with numerous small pustules that merge to form wedge-shaped and deep into the parenchyma of the organ. The basis of the focus of inflammation adjacent to the shell of the kidney involved in an infectious process (perinephric).
In the first stage of the disease the bottom of the carbuncle more thick, infiltrated and soldered to the shell of the kidneys over time it purulent fusion. In most cases, the inflammatory process involves the layers of fat tissue. Initially, it swells and infiltered, then the development of purulent paranephritis.
If the carbuncle develops in the upper segment of the kidney, the resulting infiltration can go to the adrenal gland, causing loss of function and causing the reactive pleurisy.
In case of secondary acute pyelonephritis complicated by a purulent inflammation of tissue with the formation of the carbuncle, the clinic of the disease resembles in its manifestations aposematism pyelonephritis, the cause of which is the violation of the outflow of urine.
In those rare cases when pathologydevelops without a change in urodynamics and a carbuncle is a limited hematogenous tumor in the body, symptoms have a lot in common with a clinical picture of common infectious diseases. The patient suffers from high temperature (39-40 degrees Celsius), severe chills, excessive sweating, General weakness, high pulse rate and respiration, nausea, vomiting, bloating, constipation.
The symptoms of carbuncle of kidney in the initial stage of the disease are not accompanied by local pain in region of kidneys, in addition, the study in the urine are not detected by white blood cells and bacteria, there is urination disorder, which causes difficulties for physicians during diagnosis. For this reason, patients with carbuncle of the kidney undergo hospitalization with incorrect set of diagnoses, such as influenza, pneumonia, typhoid, etc.
Treatment of carbuncle of kidney
Treatment of carbuncle of kidney the most powerful broad-spectrum antibiotics is not effective without surgery. Carbuncle must be open and drained the cavity.
Formulation of such diagnosis implies an urgent operation, which includes lumbotomy, decapsulate kidneys, cruciate incision of the carbuncle, or excision, drainage of parametria. The kidney are treated rubber-gauze, not sewing up one of the corners of the wound. If stagnation of urine is draining.
On the second day after the operation the tampons you need to change the rubber graduates. The wound for a long time to drain it until completely clean it from dead skin cells before the appearance of juicy granulations.
Given the results of the urine culture, a treatment with antibiotics, patients are prescribed detoxication therapy, performed gymnastics.
When severe purulent or septic intoxication after surgery treatment complement methods of extracorporeal detoxification, patients are prescribed hemosorption, plasmasorption, plasmapheresis. Operated patients over the years see's specialists clinics.
While numerous carbuncles the kidney, intactness the second kidney and its normal operation is carried out nephrectomy, especially if the patient is elderly or in old age.