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Pyelonephritis in infants

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Pyelonephritis in infants is an inflammation of the kidney in a child who is breast-feeding, which is triggered by pathogenic microorganisms.

Girls are more vulnerable to infection than boys, they have pyelonephritis diagnosed 6 times more often. In infants pyelonephritis is diagnosed mainly in 4-5 months, when they begin to translate to artificial feeding. In newborns, the disease is detected in 1-3% of cases and most of these children prematurity.


The symptoms of pyelonephritis in infants

The course of disease in infants is somewhat different and depend on the age of the child.

So, infants will display the following symptoms:

  • The body temperature increase to high values, the fever will last from two days or more;
  • A complete rejection of suckling;
  • Increased regurgitation;
  • Urine has an unpleasant odor;
  • Vomiting;
  • Bowel disorders with a predominance of liquid stool;
  • During urination, the newborn may exhibit anxiety, which is expressed in lamentation;
  • The child may show increased drowsiness
  • The urination occurs in small portions;
  • The younger the age of the child, the faster it will be to lose weight, especially given the high temperatures.

In the neonatal period pathogenic bacteria causing pyelonephritis, circulate in the blood, so symptoms are not specific to this inflammation:

  • Body temperature can fall to critically low values, or to achieve high marks, causing fever;
  • Often there is yellowing of the skin;
  • The child refuses suckling;
  • Observed repeated regurgitation and vomiting;
  • In newborn male infants revealed hyponatremia and hyperkalemia, although perhaps the development of these States and girls;
  • Childdevelopment is delayed.

Causes of pyelonephritis in infants

In most cases in the neonatal period cause the development of the disease is the introduction of bacteria into the blood of the child. Circulates through the bloodstream, they are, by hematogenous reach the kidneys and cause inflammation of tissues and systems. Therefore, almost any microbe can lead to the development of disease in the newborn.

With regard to infants, the more common ascending route of infection, when pathogens penetrate into the kidneys from the bladder. In most cases, pyelonephritis in infants is provoked by E. coli (see also: Causes and symptoms of E. coli) although it can occur the introduction into the tissues of the kidneys clusively, bacteria of the enterococci group, rarely staphylococci, streptococci, viruses and fungi. It is not excluded the renal microbial associations.

The development of the disease caused by the following factors:

  • Purulent omphalitis of newborn;
  • Pneumonia;
  • Sore throat;
  • Dysbacteriosis of the intestine;
  • Pustular lesions of the skin;
  • Intestinal infection;
  • Vulvity, vaginitis, cystitis, balanoposthitis;
  • The improper and insufficient child care, improper cleaning babies;
  • Anomalies of the urinary system that obstruct the normal passage of urine;
  • Congenital malformations of the kidneys;
  • Vesicoureteral reflux;
  • Malnutrition;
  • Prematurity;
  • Rickets;
  • Excess vitamin D;
  • Infectious diseases that contribute to the decline of the immune forces of the body.

Diagnosis of pyelonephritis in infants

Typically, the first pyelonephritis in infants diagnose the pediatrician sends the child with the parents on a compulsory consultation with a children's nephrologist, or a pediatric urologist. To confirm the diagnosis you'll need to perform:

  • LIKE;
  • TANK;
  • OAM;
  • Urine cultureflora with mandatory antibiotikogramma;
  • Biochemical analysis of urine;
  • Trial of General is performed in the interpretation of Reyzelman, when the urine collection is carried out every 3 hours, and in the rhythm in which the child urinates;
  • Possible detection of the disease by PCR and IFA;
  • It is important to assess spontaneous urination and the control of diuresis.

Also the child will go for an ultrasound of the kidneys and bladder. Cystourethrography do not perform after the first episode of illness in a child is carried out with repeated pyelonephritis, or when detected during ultrasound hydronephrosis, hardening of the blood vessels of the kidneys, and obstruction.


Treatment of pyelonephritis in infants

Treatment of pyelonephritis in infants is based on the following principles:

  • Compliance with bed rest during febrile period;
  • The rejection of the introduction of complementary foods, without restriction in natural protein-rich foods;
  • Timely hygienic measures in compliance with the rules cleaning the baby;
  • Symptomatic therapy with the use of antipyretics, desintoxication and infusion of medicines;
  • The implementation of antibiotic therapy.

The main condition for removing the child from the disease is antibiotic therapy, which is carried out in three stages. In the first stage, which lasts from 10 days to 2 weeks of the child to choose a doctor treated with protected penicillins: Amoxiclav or Ampicillin in combination with Sulbactam. Also used third generation cephalosporins: Cefotaxime, Ceftazidime, Cefixime, Ceftriaxone, Ceftibuten. When the illness is severe, administered aminoglycosides (Netromycin, Gentamicin, Amikacin), cephalosporins of the 4th generation (Cefepime), or carbapenems (Imipenem, Meropenem).

The second stage of treatment is reduced to uroseptic therapy, which is performed for 2-3 weeks. It is achieved by using derivatives of 5-nitrofurans (Furagin, Furamag), and using non-fluorinated quinolone (Blacks, Nevigramon, after a year – Palin), combined sulfonamides (after the age of 2 months is allowed To trikomsel).

The third stage of treatment is to preventive anti-relapse therapy. For this for a long time (maybe years) the child is given nitrofurantoin drugs – Furagin, Furamag and carry out a course of herbal medicine, preferably manufaoture taking into account individual intolerance.

As herbal remedies for the prevention of pyelonephritis in infants, you can use Kanefron N, offering child 15 drops up to 3times a day.

For the treatment of dysbiosis used probiotics (Linex, Acipol). During the month the child is given vitamin a, B6, E, which is essential for antioxidant therapy. In subsequent courses.

Child after an episode of acute pyelonephritis subject to dispensary observation for five years, and in return constantly.