The proportion of women with reproductive age is about 1:8. Clinical manifestations include the following three groups.
This is commonly referred to as the lower urinary tract infection. Adult women cystitis is mainly urinary irritation, namely, urinary frequency, urgency, urine pain, urine WBC, accidentally can have hematuria, even to the naked eye hematuria, urinary bladder area can have discomfort. Generally no obvious systemic infection symptoms, but a few patients can have lower back pain, low thermal (generally no more than 38 ℃), increased blood leukocyte count is often not. More than 30 percent of cystitis is self-limited, but within 7 to 10 days it can heal itself.
2. Acute pyelonephritis:
Symptoms include: urinary symptoms: bladder irritants, such as urinary frequency, urgency, and urinary pain, and lower back pain and (or) lower abdominal pain. Symptoms of systemic infection: chills, fever, headache, nausea, vomiting, loss of appetite, etc. There is no hypertension or nitrogen.
3. Chronic pyelonephritis:
The course of chronic pyelonephritis is very secluded. Clinical manifestations of pided into the following three categories: (1) urinary tract infection (uti) performance: only a few can occur intermittent symptomatic patients with pyelonephritis, but the performance of the more common for asymptomatic bacteriuria intermittently, and (or) of intermittent urgency, urinary frequency and urinary tract infection symptoms, waist and abdomen discomfort and (or) of intermittent low thermal. The performance of chronic interstitial nephritis, such as high blood pressure, increased urine, increased night urine, and dehydration. The related manifestations of chronic kidney disease.
4. Atypical urinary tract infection:
The symptoms of acute infection in the body were mainly performed, while the local symptoms of urinary tract were not obvious. The symptoms of urinary tract are not obvious, and the symptoms of acute abdominal pain and gastrointestinal disorders are mainly manifested. The main manifestations of blood urine, mild fever, and low back pain. There is no obvious urinary tract symptom, only showing back pain or waist pain. In the minority, there was a small number of people who were suffering from renal colic and hematuria. There was no clinical symptoms at all, but the urinary bacteria were cultured and the colony was greater than 105 / ml.
Second, diagnostic criteria:
When a patient meets one of the following conditions, he can be diagnosed with urinary sensation:
The typical urinary tract infection and urination (the centrifugal-diuresis of the white cells, >, 5 / HP), and the nitrite test were positive;
The number of white blood cells in the middle section of a clean centrifuge, or those with urinary tract infection, > 10 / HP;
(3) with symptoms of urinary tract infection (uti) + urine bacterial quantitative culture midway through regular cleaning in the morning, colony number 105 or higher/ml, and two consecutive urinary bacterial counts 105 / ml, or two bacteria and subtypes of the same;
To develop bladder puncture, such as bacterial positive (no matter how many bacteria);
The symptoms of typical urinary tract infection, the treatment of the urethral diuresis in the morning before the treatment of the urethral diuresis, the bacterium, the bacteria > 1 / oil mirror view.
Chronic pyelonephritis: X-ray vein angiography (IVP) of the renal pelvis see focal, rough cortex might mark, with the expansion of the accessory renal papilla contraction and dull signs can be confirmed.
Urinary tract infection can be pided into upper urinary tract infection and lower urinary tract infection, the former is pyelonephritis, which is mainly cystitis. Pyelonephritis and cystitis are also acute and chronic. According to the basic disease, urinary tract infection can be pided into complex and non-complex urine.
Chronic pyelonephritis often due to the complexity of urinary tract infection in delay will be caused by, according to the fundamental cause pided into three types: (1) associated with chronic pyelonephritis reflux (reflux nephropathy); Chronic pyelonephritis with obstruction (chronic pyelonephritis); Idiopathic chronic pyelonephritis. The first two types are particularly common.
Urinary tract infections of different bacterial infections:
Chlamydia urinary tract infection: men often feel urethra tickling and weight of urinary pain and a burning sensation, the pain is lighter gonorrhea, urethral opening mild redness, very serous or slurry purulent urethral discharge. Women with major parts for the cervical infection, urinary tract inflammation is not obvious, often characterized by the acute and chronic cervicitis and cervical erosion, leucorrhea increase or mild dysuria and urinary frequency, can be completely asymptomatic.
Mycoplasmic urinary tract infection: acute pyelonephritis, such as fever, lumbar pain, bladder irrigations, and increased urination in urine, etc. It can also show symptoms of urinary tract infection; Typical performance for urethral tickling and weight of the urine pain and a burning sensation, urethral opening mild redness, very serous or slurry purulent urethral secretions women with major parts for the cervical infection, urinary tract inflammation is not obvious, characterized by the acute and chronic cervicitis and cervical erosion, leucorrhea increase or mild dysuria and urinary frequency, can be completely asymptomatic.
Fungal urinary tract infection: there are no symptoms and only suppurate, which can also show typical urinary tract infection and even kidney failure. There are systemic fungal infections, often with fever, chills and other systemic symptoms.
Parasitic urinary tract infection: the clinical manifestations of trichomonitic urinary tract infection are identical to those of bacterial urinary tract infection. Urinary amoeba disease is different from infection and infection. Clinical symptoms are non-specific and similar to normal bacterial urinary tract infection. Urofilariasis is found in the extremities and forms such as puffy, scabbard and local lymphatic dilation. Some of the patients are in the form of spermatitis, epididymis and orchitis. The disease can be a few years or decades. The cyst increases and causes the surrounding glomeruli to collapse, and occasionally a cyst through the pelvis or abdominal cavity. When worn into the abdominal cavity, can cause hives, asthma, fever, abdominal pain and other allergy symptoms, the severe person can have anaphylactic shock.
Urinary tract infections in different populations:
Urinary tract infection: menopause menopause women the main symptoms of urinary system infection including frequency, urgency, dysuria, night urination, urine is not the feeling and the tension of urinary incontinence, etc.
Pediatric urinary tract infection: it is rarely confined to one part of the body, sometimes difficult to distinguish, so it is commonly referred to as urinary tract infection. In the case of acute urine, children are not as experienced in urine, urine, and urine, and their symptoms vary widely. When a newborn is ill, the weight is different.
Elderly urinary tract infection: early and late diagnosis of urinary tract symptoms is not obvious. Slow periods can be fatigue, back pain, anemia, high blood pressure, pus, and proteinuria. Inpidual performance is different, but progressive progress can affect kidney function.
Postpartum infection: postpartum complications. Urinary frequency, urgency of urine, urine pain, etc., the kidney area has the tenderness or the pain. Postpartum appear chills high fever, temperature up to 39 ℃ above, can appear reflective vomiting.
Urinary tract infection during pregnancy, pregnancy is a sensitive period, the incidence of urinary tract infection is quite high, many patients with asymptomatic bacteriuria during this period of asymptomatic bacteriuria, urinary tract infections are common during pregnancy.
(1) systemic infection. Some of the local symptoms of urinary tract infections is not obvious and acute systemic symptoms of infection called prominent, easily misdiagnosed as influenza, malaria, septicaemia, febrile diseases such as typhoid fever. If you can inquire about the history of the disease in detail, pay attention to the symptoms of urinary tract infection and the pain in the kidney area, and make the urine sediment and bacteriological examination, which is not difficult to identify.
Chronic pyelonephritis. With recurrent urinary tract infection (uti) for differential diagnosis, now think imaging examination found that focal rough renal cortical scar, accompanied by corresponding calyces deformation, can be diagnosed as chronic kidney inflammation of the renal pelvis, or history of urinary tract infection (uti) is long, also cannot be diagnosed with the disease. The disease often have generally chronic interstitial nephritis, and a history of intermittent urinary tract infection attacks, in the urinary tract without complex rare chronic pyelonephritis, urinary tract have a functional or organic obstruction occurs. Urinary tract functional obstruction is common in bladder - ureteral reflux, whereas organic matter is seen in kidney stones and so on.
(3) kidney tuberculosis. The disease frequency, urine, urine pain more outstanding, generally antimicrobial drug treatment is invalid, the morning urine culture n/med tuberculosis bacili masculine gender, urine sediment acid fast bacilli can be found and ordinary germiculture negative. The tuberculin test positive, the serum tuberculosis bacterium antibody measure Yang sex. Intravenous pyelography can be found in the renal tuberculosis range, which can be identified in some patients with renal tuberculosis such as lung and epididymis. But it is important to note that renal tuberculosis is often associated with urinary tract infection. After the treatment of antibacterial drugs, urinary tract infection and residual urinary tract infection may be the most important thing. (4) urethra syndrome. Although the patient has frequent urination, urgency, and urinary pain, there is no such thing as true bacterial urine. Urethral syndrome can be pided into: (1) infectious urethral syndrome: accounts for about 75% of patients with urine WBC, is caused by pathogenic microorganisms, such as chlamydia, mycoplasma infection, etc. (2) noninfectious urethral syndrome: accounts for about 25%, no white cells in the urine, pathogen examination is negative, its etiology is unknown, some people think that may be caused by anxiety mental state.