What is kidney carbuncle? How does this disease manifest itself and why does it develop at all? We will answer these and other questions regarding the mentioned pathology in the materials of the article under consideration.
Basic information
What is a kidney carbuncle? In modern medicine, this term is used to refer to a purulent-necrotic formation that forms in the cortical substance of the mentioned organ. The main reason for the development of this disease is the penetration of a bacterial pathogen into the kidneys. It comes from a distant purulent focus along with the blood flow.
It should be especially noted that if the inflammatory process in the kidneys in question was not cured at the initial stages of its development, then very soon a purulent fusion of the outer walls of the developed formation can occur and, as a result, the release of its contents with further penetration into the pelvis, medullary layers of the kidney or perinephric tissue. According to experts, such complications significantly aggravate the course of the disease.
Main reasons for development
Why does primary kidney carbuncle occur? This disease developswhen a huge amount of bacteria enters the said organ from a distant purulent focus. As a rule, this occurs by the hematogenous route. This process leads to the formation of blood clots in small and large vessels.
If a blood clot forms in only one large vessel, then there will be only one focus of septic infarction in the kidney. If small vessels are involved in this pathological process, then multiple foci appear, which slowly merge with each other.
So why does kidney carbuncle occur? Remote causes of infection that can cause this pathology are:
- osteomyelitis;
- mastitis;
- furunculosis;
- purulent skin lesions;
- peritonsillar abscess;
- panaritium.
In the event that the causes of the formation of the pathology in question are associated with pyelonephritis (including acute), a purulent focus may occur due to compression of vessels (small or large) by an inflammatory infiltrate.
Experts say that Proteus, staphylococci and Escherichia coli are most often involved in the formation of the carbuncle of the kidneys. The combined effect of these bacteria is also sometimes observed.
Other reasons
What to do with the development of formations on the kidneys? Only an experienced urologist will tell you about this. The clinic and its specialists will help the patient not only diagnose this disease, but also determine the correct and effective treatment tactics.
For what other reasons does the pathology in question occur?In isolated cases, this disease is associated with the occurrence of obstacles that impair the outflow of urine. They can be benign and malignant formations in the urinary organs, calculi in the ureters and prostate adenoma.
It should be especially noted that the likelihood of carbuncle formation under the influence of the above factors increases significantly with reduced human immunity.
Appearance of education
What does the carbuncle of the left kidney (or right) look like? Visually, such a formation is a bulge, which has a rounded shape. At the same time, on its section, you can see that it consists of small necrotic areas of tissue containing small pustules.
Usually, in the process of development, the carbuncle passes into the parenchyma of the kidney. As for the base of this formation, it is adjacent directly to the fibrous membrane.
It is impossible not to say that the inflammatory process in the kidneys may be involved in their shell and fiber. If the focus is located in the upper region of the mentioned organ, then the infiltrate is able to pass to the adrenal gland. At the same time, signs of its hypofunction very often develop.
Main symptoms of the disease
What are the symptoms of kidney carbuncle? This disease can have a completely different clinical picture. In some cases, the signs of the disease in question are most pronounced. Although it often happens that this pathology does notdoes not show.
In the event that the urodynamics in the event of a purulent-necrotic focus is not disturbed, then the symptoms of this disease are very similar to the course of a normal infectious process. In this case, the patient has:
- profuse sweating;
- chill;
- tachycardia;
- temperature increase (up to 40 degrees);
- nausea;
- breathing;
- vomit;
- flatulence.
It should be especially noted that on the first day of carbuncle formation, the patient has no signs of urination disorders. Also, patients do not have severe pain. However, some people experience only slight discomfort in the lumbar region. However, during the study of urine in such patients, an increased number of leukocytes is detected. In the last stages of the disease, pyuria (that is, pus in the urine) is also detected.
Other signs of pathology
Where does it hurt if a carbuncle develops in the kidney? The symptoms of this disease partly depend on where the pathological focus is located, as well as on the activity of the inflammatory process and the presence of concomitant abnormalities.
It cannot be said that the clinical picture of carbuncle is determined by the appearance or absence of complete or partial blockage of the urinary tract.
So where does it hurt with such a disease? According to experts, in the later stages of the disease, the patient has pain in the lower back. Moreover, on palpation of the place of discomfortswelling on the back is quite easily detected, in particular on the side of the direct lesion.
Similarities of symptoms
Appointment with a urologist, as well as his consultation with the development of a carbuncle of the kidneys, is a mandatory procedure. This is due to the fact that if the treatment was not started on time, then the progression of the purulent process contributes to the development of symptoms of appendicitis.
Very often considered disease has signs similar to the clinical symptoms of cardiovascular pathologies, liver damage and neuropsychomorphic diseases. Such a course of the disease can quite easily lead to an incorrect diagnosis and, accordingly, incorrect treatment, which subsequently complicates the course of the underlying disease.
No signs
Regular appointments with a urologist, as well as a complete medical examination of the patient, are also necessary because the carbuncle of the kidneys can be asymptomatic or with signs of liver dysfunction. This state of affairs can lead to the fact that treatment will not be prescribed on time, and the developing disease will cause thromboembolism of blood vessels in the pulmonary artery or brain.
Diagnostic process
Who should diagnose the disease in question? This specialist is a urologist. The clinic where this doctor sees may be private or public. In any case, the process of diagnosing a carbuncle of the kidney requires a special approach and experience.
Due to the fact that this disease has no specific symptoms,diagnosis is possible only in the presence of local swelling and tenderness, as well as x-ray data.
According to the statements of experts, it is very easy to identify carbuncle (causes and treatment are discussed in this article) only if it is combined with a lesion of the pyelocaliceal system of the kidneys. Also, this disease is diagnosed in the process of examining urine, in which a huge number of leukocytes are detected.
If the carbuncle is localized in the cortical substance of the kidney and the patency of the urinary tract is not impaired, then it is quite difficult to identify the disease.
The process of conducting an X-ray examination in such a disease reveals a reduced respiratory excursion of the diaphragm. Sometimes the carbuncle may even look like a tumor.
In ultrasound and computed tomography, such a pathology is often defined as a formation of a round or oval shape. If the carbuncle is large, then the presence of deformation is detected in the pyelocaliceal system of the kidney.
Drug therapy
Preparations for the kidneys and formations in them are sold in many pharmacies. However, these medicines should only be taken when prescribed by an experienced doctor.
Many experts say that even after successful treatment of kidney carbuncle, it can recur. As a rule, this happens if the cause of its occurrence has not been completely eliminated.
When a carbuncle is detected in the early stages of its development, patientsantibiotic treatment may be offered, but only strictly under the supervision of a urologist. It should be noted that in most cases, such therapy does not give proper results, since purulent formation significantly impedes blood flow in the kidney, which does not allow antibacterial substances to penetrate into the lesion.
Recently, the disease under consideration has been treated in a complex manner, using not only antibacterial drugs, but also such a remedy as "Cryoprecipitate". The latter is a kind of concentrated mixture obtained from blood plasma. Treatment with this medicine helps to increase the content of fibronectin in the blood, which subsequently helps to restore blood flow in the affected areas of the kidneys.
Surgical treatment
Most often, after the detection of a carbuncle of the kidneys, patients are prescribed emergency surgical treatment, which is carried out by lumbotomy. It should be especially noted that the tactics of such therapy depends on the patient's condition, the type of kidney damage, as well as the quality of work of another paired organ.
If the disease in question has destroyed a large area of the kidney, then the person is prescribed a nephrectomy. Usually this method of treatment is indicated for older people.
With organ-preserving surgery, which was performed in a timely manner, the recovery period of the patient proceeds without any complications. At the same time, patients note a decrease in body temperature and the disappearance of other symptoms of the disease.
During the rehabilitation period, the patient may beantibiotics were prescribed. By the way, their choice depends on the sensitivity of the detected microorganisms to various medicines. Also, such patients are shown laser treatment, detoxification therapy and exercise therapy.
