Pyelonephritis is a complex inflammatory process of the kidneys. This disease can occur at any age. It is dangerous because it develops very quickly, therefore it requires urgent medical care.
Pyelonephritis in newborns poses a threat to life, as it can not always be detected in the initial stages. Complications can affect other organs, so the child often ends up in the intensive care unit.
Feature of the disease
The kidneys play a very important role in the human body. They are responsible for the excretion of toxic substances and decay products along with urine.
This organ regulates s alt and water balance in the body, is responsible for the production of vitamin D, and also releases some active components responsible for hemoglobin levels and pressure regulation. The proper functioning of the kidneys largely depends on the full functioning of other organs in the child. Therefore, it is important to recognize pyelonephritis in newborns in order to prevent the development of complications.
When the disease progressesnot only the kidneys themselves become inflamed, but also the pelvis. In this case, there is a serious violation of the outflow of urine. This threatens with very serious consequences and various complications.
Main classification
According to the classification, pyelonephritis in newborns can be primary and secondary. The primary form of the disease occurs without any prerequisites and urological diseases. The infectious process begins to develop in an initially he althy organ. The secondary form of the disease is characterized by the fact that the pathology is formed in the presence of inflammation of the urinary tract. This is the most common type of disease.
According to the stage of the course, pyelonephritis in a newborn can be infiltrative and sclerotic, and according to localization - unilateral and bilateral. Initially, the child has an acute form of the disease, and the symptoms are quite pronounced. If you do not carry out comprehensive and timely treatment, then it turns into chronic pyelonephritis.
The disease can occur in a latent form, and in this case, the urinary syndrome is only slightly manifested. This is the most insidious type of disease, as it is almost impossible to detect it in a timely manner.
Causes of occurrence
The causes of pyelonephritis in newborns are mainly associated with the penetration of infectious agents into the kidneys. Often, the disease is provoked by Escherichia coli, but many other bacteria, in particular, enterococci, Klebsiella, and Proteus, can act as the causative agent. They enter the kidneys through the circulatory system, lymph or from the urethra.
Most often, pyelonephritis of the kidneys in newborns develops due to the penetration of bacteria in an ascending way. They come from the perineum and rectum. The introduction of bacteria is facilitated by improperly carried out hygiene measures, as well as a sharp weakening of the immune system. In the presence of predisposing factors, the infection rises to the bladder and then to the kidneys.
The causes of pyelonephritis in a newborn boy may be associated with the presence of other diseases. In this case, the affected bronchi, tonsils, umbilical process, and pharynx serve as the source of infection. Against the backdrop of a weakened immune system, bacteria enter the bloodstream and then spread to the kidneys.
Very rarely, the infection spreads through the lymphogenous route. This occurs when the mucosa of the urinary tract is damaged and bacteria spread from the rectum. There are several causes of pyelonephritis in newborns, including:
- congenital pathologies of the structure of the urinary system;
- pregnancy pathologies;
- violation of the composition of urine;
- prolonged hypothermia;
- presence of inflammatory diseases;
- feeding formula;
- presence of worms;
- some comorbidities.
In case of advanced acute inflammation, chronic pyelonephritis occurs. The disease develops against the background of the lack of a full-fledged treatment or the use of ineffective antibacterial drugs. Sometimes chronicity can be triggered by some congenital pathologies of the immune system.system.
Symptoms of the disease
Symptoms of pyelonephritis in newborns are quite specific. Babies cannot indicate pain and describe their feelings. Parents guess about the ongoing pathology only by indirect symptoms.
The most characteristic symptom of pyelonephritis is an increase in temperature to 38-39 degrees. In a child of 3 months, the fever is more pronounced, and the temperature can rise to 40 degrees. The course of the disease without fever is typical for premature babies.
In addition, the baby shows a lot of anxiety. The skin of a newborn becomes painfully pale. The baby refuses to eat and begins to lose weight dramatically. The clinical picture may be accompanied by nausea and diarrhea.
In some cases, parents with pyelonephritis in a newborn boy note a violation of urination. The jet becomes intermittent and weak.
The disease is also characterized by a change in the quality of urine. It forms a cloudy precipitate. Urine can also contain minor blood impurities and have a rather unpleasant odor. An exacerbation of the chronic form of pyelonephritis has exactly the same symptoms as the acute course of the disease. The period of remission is characterized by the complete absence of signs of the disease. Sometimes such a pathology is accompanied by a constant slight increase in temperature.
Diagnostics
To diagnose "pyelonephritis" in newborns, at the first signs of leakageillness, parents should contact a pediatrician, who, after examination, refers to a nephrologist. If the assumptions regarding the presence of pyelonephritis are confirmed, the nephrologist gives a referral for a general and biochemical blood test, as well as a urine test.
In some cases, ultrasound diagnostics of the organs of the urinary system, excretory urography, radiography, and tomography may be additionally prescribed. In case of a particularly severe course of the disease, a special needle is inserted into the kidney and a small amount of tissue is subsequently taken for morphological examination.
Feature of treatment
To eliminate the symptoms and causes of pyelonephritis in newborns, treatment must be comprehensive. When the first signs of illness occur, the baby, together with the mother, is hospitalized in a specialized hospital, where diuresis and the general condition of the baby are traced. Based on this, therapy is selected and adjusted.
Definitely requires specialized medical treatment. In particular, drugs such as:
- antibiotics;
- uroseptic;
- antipyretic;
- anti-inflammatory;
- antifungal;
- antispasmodics;
- immunomodulators;
- probiotics;
- phytopreparations.
Inpatient treatment continues for 3-4 weeks. Preparations are strictly selected by the urologist or nephrologist, giving preferencethe most optimal combinations. It is strictly forbidden to independently treat pyelonephritis in newborns, since many drugs are strictly contraindicated in infants or are not effective enough when taken simultaneously.
Drug therapy
The main principle of the treatment of pyelonephritis in newborns is the appointment of effective and rational antibiotic therapy. Until the results of the diagnosis are obtained, doctors prescribe broad-spectrum drugs. The most commonly used antibiotics are from the penicillin group. These include "Amoxiclav", "Amoxicillin". In addition, infants are also allowed to take cephalosporins, in particular such as Ceftriaxone, Cefuroxime.
Duration of therapy is 7-10 days. It is strictly forbidden to cancel the use of drugs prematurely, as this leads to a steady growth of pathogenic microflora.
If all these groups of drugs are ineffective, other antibacterial agents can also be prescribed. Newborns are prescribed macrolides and carbapenems. With a particularly severe course of the disease and the presence of highly resistant pathogens, broad-spectrum antibiotics, fluoroquinolones, aminoglycosides may be indicated.
For symptomatic therapy, drugs are used that normalize the outflow of urine. The most popular is "Kanefron". Such a drug contributes to a more rapid discharge of infected urine and the death of bacteria. Children are showntaking vitamins. After a course of antibiotic therapy, the use of probiotics is indicated, which help restore the normal intestinal microflora.
If a fungal infection of the kidneys has been proven, then antifungal agents are prescribed in tablet form. During their administration, control of therapy with the help of urography and other methods is required. After a course of antibiotic therapy, uroantiseptics are prescribed, as this helps prevent the disease from flowing into the chronic stage. These antimicrobials help eliminate ongoing inflammation.
Antihistamines are prescribed to eliminate swelling and inflammation. In addition, they help to stop the signs of allergies in case of a reaction to the antibacterial agents used. In rare cases, severe kidney damage may require surgery.
Compliance with the regime
Pyelonephritis is mostly treated in a hospital and only in some cases at home. Therefore, parents must follow a certain regimen for the period of therapy.
It is important to carry out exclusively natural breastfeeding during the treatment. Good hygiene for the newborn is also important.
The flow of the infectious process into the chronic stage is a particular danger to the he alth of the child, and constant exacerbations significantly impair the quality of life. Prolonged course of pyelonephritis leads tovarious complications. After suffering an acute form of the disease, a mandatory dispensary registration is indicated once every 6 months for 5 years.
Possible Complications
In the first month of life, the size of a kidney in a baby is approximately 5 cm. Bacteria very quickly infect this organ of a baby. That is why pyelonephritis progresses very quickly, significantly increasing the risk of complications. This is very dangerous, as it threatens to damage other organs. The consequences of pyelonephritis in a newborn boy or girl may be as follows:
- transition of an acute form into a chronic one;
- hydronephrosis;
- arterial hypertension;
- sepsis;
- necrosis of the tubular system;
- multiple kidney abscesses.
As a result of the increased load on the heart and pressure, hypertension begins to develop. Complications are very severe, which is why, in order to prevent them, you need to consult a pediatrician in a timely manner.
Prophylaxis
The occurrence of pyelonephritis and its complications is quite possible to prevent, the most important thing is to follow certain preventive measures, in particular:
- carefully monitor the hygiene of the newborn;
- put on diapers before going to bed or for a walk;
- women need to diet while breastfeeding;
- pass periodic preventive examinations;
- in cool weather, warmly dress the child;
- maintain immunity;
- when the first signs of the course of the disease are detected immediatelysee a pediatrician.
After a previous pyelonephritis, a child should be registered with a urologist. Consultations and examinations by a nephrologist will also be required. Special care should be taken when vaccinating. With the course of acute pyelonephritis in a child, vaccination up to one year of age may be postponed until the state of he alth is completely normal.
If the child has already had the disease once, then it is necessary to take preventive measures so that relapses do not recur. To prevent the development of chronic pyelonephritis, it is essential:
- make sure that the emptying of the bladder is frequent and timely;
- control that the baby sleeps well, drinks enough fluids, takes vitamins;
- organize frequent outdoor walks;
- periodically do a biochemical blood test.
Pyelonephritis is a very serious disease, especially for babies. With incorrect or untimely treatment of the acute form, the disease can go into a chronic stage, which is fraught with dangerous complications and frequent relapses.
