Investigation of patients with signs of infection is started by history and physical examination ac

Perirenal abscess is a collection of pus and necrotic cell debris material, located in the perirenal space. Usually occurs as a complication of urinary tract infections, especially in situations where the initial diagnosis was obstructive pyelonephritis (usually caused by gram-negative infections or plurimicrobiene). And abscess may develop after hematogenous seeding, or systemic infections with Staphylococcus aureus. Because such a condition has a high morbidity and mortality, it is important that the diagnosis be established as quickly as possible, and treatment is started immediately. Suspicion diagnose must occur in any patient complaining of abdominal pain or flank, has a fever and has chronic conditions such as diabetes or kidney abnormalities: neurogenic bladder tumors obstructive benign cysts, polycystic kidney disease, reflux vezicouretral. Thanks to advances imaging techniques and frequent use of CT for the diagnosis, nyx the disease is rapidly nyx identified nyx and antibiotic treatment can be established more quickly. nyx Perirenal abscess is a serious complication, but not frequency of urinary tract infections. Its incidence ranges from 1 to 10 cases per 10,000 hospital stays. Approximately one third of patients experiencing nyx such a problem and diabetes were concurrently.
Perirenal abscess is a collection of purulent material that forms around the kidneys. It insidious evolution for over 14 days, and most often occurs due to complication of urinary tract infections or marrow expansion about other infectious nyx outbreaks. Etiologic agents frequently incriminated nyx in causing disease are Escherichia coli, Proteus species and Staphylococcus aureus. Due to various infections antibiotic treatment administration, it seems as frequent germs begin to change. Thus, as a result of antibiotic therapy for skin infections, staphylococcal etiology was reduced from 45% to 6% (over the last 60 years). There are other germs that can cause such an abscess: Klebsiella, Enterobacter, Pseudomonas, Serratia, Citrobacter and. Occasionally, the infection can occur with enterococci, or even fungi: Candida or Mycobacterium. In over 25% of the abscess has pluribacteriana flora.
There are several risk factors that predispose patients to the occurrence of such infectious diseases nyx - renal papillary necrosis; - Obstructive nyx kidney nyx stones; - Tuberculosis Genitourinary - Injuries: renal biopsy, urologic surgery; - Vesicoureteral reflux; - Neurogenic bladder; nyx - The state of immunosuppression; - Intravenous drug abuse; - Diabetes.
Perirenal abscess is located between the renal capsule and Gerota fascia. Renal capsule is a layer of fibrous tissue nyx that adheres to the surface intimately overlapped kidney and renal adipose tissue. It is a protective structure, both to the trauma, as well as any extensions to tumor. Gerota fascia or fascia kidney is the layer of connective tissue that encapsulates the entire kidney, as it is finding other fibrous structures. Following this locations and roles structures with which it is in contact renal abscess remains located at this level. Abscess occurs in most cases due to the merger of intrarenal abscesses corticomedullar, or local complications of pyelonephritis evolution with recurrent pyelonephritis xantogranulomatoase, or of obstructive renal calculi determines pyonephrosis. Sometimes, the abscess may evolve as a result of the spread of infections that initially extraperitoneal locations, nyx such as in appendicitis retroperitoneal, diverticulitis, pancreatitis, pelvic inflammatory disease. Patients with polycystic kidney disease and those who are on hemodialysis (for whatever reason) have a higher susceptibility to develop perirenal abscesses.
Picture symptomatic patients with perirenal abscess may be relatively nonspecific and therefore exact diagnosis is established sometimes with some delay. Typically, patients initially presenting with infection in other areas of the body, urinary infections or skin infections. Initial infection is followed, in 1-2 weeks of fever and pain unilateral localized flank. The most common symptoms are: - Fever (in 90% of cases); - Abdominal pain (40-50%); - Chills (40%); - Dysuria (40%); - Weight loss; - Lethargy; nyx - Gastro-intestinal symptoms (25%); - Pleuritic pain (due to irritation of the diaphragm); - Irradiated pain in the scrotum, thigh, knee (if abscess click on certain nerves).
Investigation of patients with signs of infection is started by history and physical examination achievement. The