Urinary tract infection of the emergency clinical manifestations

According to the bladder inflammation etiology, pathology and pathogenesis methods can be divided into acute cystitis, chronic cystitis, urethral syndrome, cystitis glandularis, And are not infected interstitial cystitis and radioactive bladder. While pyelonephritis also can be divided into acute pyelonephritis and chronic pyelonephritis. In addition, there are kidney own renal papillary necrosis infection, renal cortex abscess, renal abscess, such as renal abscess around. Because of their different types of clinical, clinical symptoms are varied. This section only focused on acute cystitis and acute pyelonephritis two.
(1) acute cystitis was particularly prevalent in women, often from the uplink of the urethra caused by infection, sometimes come from the spread of pyelonephritis. More than sexual intercourse, or Cold exhaustion after. The major clinical manifestation is the onset of intense, frequency and urgency was clear, hourly voiding one or two, or even five to six times more frequency serious like incontinence. Voiding a burning sensation when urethral each little, or even less than 10 ~ 20 ml, the so-called bladder irritation sign. Voiding terminals have lower abdominal pain, turbid urine, and sometimes to see gross hematuria, clinical called acute hemorrhagic cystitis. Urine large or in the red blood cell, without tube. Symptoms can disappear in a few days. Systemic symptoms very light or absent. More men cystitis prostatitis and kidney secondary to the infection, or with residual urine caused by prostatic hyperplasia.
There urethral syndrome is a syndrome in female patients with frequency, urgency, but urine culture had no significant negative bacteria or urine, clinical symptoms difficult to identify and cystitis.
Because the treatment of acute cystitis is not complete, can be translated into chronic cystitis, chronic symptoms of frequency, urgency symptoms, but not as severe acute cystitis, urine or in the middle of a small amount of and erythrocyte. These patients are more acute cystitis history, and some patients with obstructive stones or other factors. Chronic cystitis easy with chronic pyelonephritis.
(2) acute pyelonephritis the disease was particularly prevalent in women, mainly E. coli bacteria, lesions can be unilateral or bilateral renal involvement. Pathological manifestations of renal pelvis, renal calyceal congestive edema, a pus surface review, kidney infection and more concentrated in the real one or more wedge, the wedge tip in the medulla, cortex in the basement, but not involved glomerular. Typical of acute pyelonephritis with three sets of clinical manifestations.
1. Bladder stimulate more symptoms associated with pyelonephritis cystitis, so patients frequency, urgency,and other symptoms of bladder stimulation. Urine turbidity, sometimes hematuria. Patients have varying degrees of low back pain or lumbar acid, in severe pain to, medial thigh and perineum radiotherapy.
2. Systemic symptoms include chills, fever, body temperature at 38 ~ 40 ° C, malaise, anorexia, sometimes nausea, vomiting, abdominal distension and severe abdominal pain, often misdiagnosed as acute cholecystitis or acute appendicitis.
3. Signs kidney area or local chiropractors rib angle Department叩击pain and tenderness point.
Uplink infections caused by acute pyelonephritis, bladder symptoms may stimulate the body before symptoms appear blood-borne infection were first systemic infection symptoms, after lower urinary tract symptoms. The disease is self-limited, the duration of symptoms three to five days gradually eased, but the urine of sustainable existence.
The so-called acute renal papillary necrosis acute pyelonephritis is a serious complication, necrosis can occur in a nipple or nipple, and more bilateral lesions. Apart from the clinical manifestations hematuria, pyuria, mainly with serious systemic sepsis-like symptoms, often septicemia shock, and there oliguria or urine closed. Renal rapid damage, acute renal failure. Renal district tenderness and peritoneal irritation, and sometimes renal papillary necrosis shedding caused colic. The disease was particularly prevalent in the urinary tract obstruction or urinary tract infection in patients with diabetes, a precarious condition, timely diagnosis and reasonable treatment.
Only half of chronic pyelonephritis onset of acute pyelonephritis, onset often hide or not typical, many patients without history of urinary tract infection, urinary no bacterial growth, or urinary tract obstruction disease. The symptoms of chronic pyelonephritis may very minor, only mild discomfort and waist stimulate bladder symptoms. Low-grade fever and anemia sometimes is the only performance. Other patients may volatility of urinary tract infection, hypertension and uremia. Urine checks often not constant, sometimes the WBC and interleukin-and sometimes close to normal, similar asymptomatic bacteria urine, it should be conducted to determine bacterial counts train diagnosis. Enrichment kidney dysfunction, one of the characteristics of this disease, unlike chronic glomerulonephritis. X-ray examination showed unilateral or bilateral renal smaller, renal calyceal expansion variant, cortical atrophy.