renal cortical medullary abscess
Introduction
Introduction to renal cortical medullary abscess Urinary tract dysfunction such as urinary tract obstruction or vesicoureteral reflux can cause renal cortical medullary abscess, which is usually caused by Staphylococcus aureus. In contrast, renal cortical medullary abscesses are often caused by infection with Escherichia coli, Klebsiella or Proteus. Renal cortical medullary abscesses in most adults are associated with kidney stones, urinary tract obstructions, or damaged kidneys. In children, it is only related to vesicoureteral reflux. Diabetes is also an important predisposing factor, especially for adult patients. A common pathogenic disease in all age groups is aerobic Gram-negative bacteria. basic knowledge The proportion of illness: 0.005% Susceptible people: no special people Mode of infection: non-infectious Complications: perirenal abscess
Cause
Cause of renal cortical medullary abscess
Acute focal bacterial nephritis is a serious acute infection of the renal parenchyma, but the infection has not yet liquefied (suppurative), it can invade one or more renal lobules, and infection is considered to be confined to the kidney with renal reflux In the lobular lobe, if the inflammatory mass is not treated in time, the inflammatory mass will be liquefied into a renal cortical medullary abscess, and the yellow granulomatous pyelonephritis often coincides with chronic urinary tract infection, kidney stones and urine. Renal cortical medullary abscess is associated with obstruction.
Most adult renal cortical medullary abscesses are associated with kidney stones, urinary tract obstructions or damaged kidneys, and in children only associated with vesicoureteral reflux, diabetes is also an important predisposing factor, especially for adult patients, all ages In the group, the common pathogenic disease is aerobic Gram-negative bacteria. Its pathogenesis is: the first invasion of the medulla by the bacteria causes medullary infection, followed by liquefaction and invasion of the renal cortex. Possible complications are abscess perforation of the renal capsule. And form a perirenal abscess.
Prevention
Renal cortical medullary abscess prevention
Develop good habits, keep the urinary tract unobstructed and prevent urinary tract infections.
Complication
Renal cortical medullary abscess complications Complications, perirenal abscess
A possible complication is that the abscess penetrates the renal capsule to form a perirenal abscess.
Symptom
Renal cortical medullary abscess symptoms Common symptoms Low back pain, chills, weight loss, fatigue, nausea, abdominal pain, gastrointestinal symptoms
Both males and females can suffer from this disease. The ratio of male to female is equal, but with the increase of age, the incidence rate is increased. The clinical features include chills, fever, low back pain or abdominal pain, urinary system symptoms, common nausea and vomiting and other gastrointestinal tracts. Symptoms, chronic patients may have general malaise, fatigue and weight loss, physical examination often no specific findings, rib angles, waist or abdomen have tenderness, rarely touch the mass.
Examine
Examination of renal cortical medullary abscess
Laboratory examination: in addition to urine analysis and urine culture positive, other examination results are the same as renal cortical abscess, which is due to the renal cortical medullary abscess and renal pelvis and renal pelvis, compared with renal cortical abscess, blood culture positive The rate is higher.
Imaging examination : Ultrasound and CT are the most basic and effective diagnostic methods for renal cortical medullary abscess. For acute focal bacterial nephritis, renal ultrasound examination often can not find abnormalities, but may show a solid hypoechoic mass, and There is no obvious boundary between the normal renal parenchyma, the kidney contour is deformed, and the cortex and medulla are unclear. CT without contrast-enhanced ultrasound often cannot confirm the symptoms of acute focal bacterial nephritis. However, after contrast enhancement, CT can show the limit. Clear, wedged and non-liquefied low-density areas can involve one or more renal lobules.
Intrarenal abscess, whether it is renal cortex or renal cortical medullary abscess, its ultrasound performance is repeated and variable, the lesion can be similar to renal cyst or renal diverticulum without internal ultrasound reflection, or a strong echogenic cluster similar to tumor, The ideal imaging examination is CT. The characteristic manifestation is that the CT value of renal parenchymal lesions drops to 0-20H units and cannot be enhanced after intravenous injection of contrast agents.
Diagnosis
Diagnosis and diagnosis of renal cortical medullary abscess
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
It is differentiated from ischemic or cystic renal tumors.
