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Pyelonephritis identification

Acute hydronephrosis is characterized by typical symptoms and abnormal urine findings and is not difficult to diagnose. If there is only high fever and the symptoms of urinary tract are not obvious, it should be distinguished from various febrile diseases. Abdominal pain, low back pain obvious, and cholecystitis, appendicitis, pelvic inflammatory disease, kidney abscess, and so on, usually after repeated examination of urine can be clearly diagnosed. The urinary tract symptoms of chronic pyelonephritis are not obvious, the urine routine has no obvious change or the urine abnormal intermittence appears. It is easy to be misdiagnosed. In women, the possibility of this disease should not be considered in cases of unexplained fever, soreness of the lumbar spine, fatigue, and mild urinary tract symptoms. Chronic urinary pyelonephritis with hypertension should be differentiated from hypertension by repeated examination of urine routine and training and finding evidence. In addition, it is necessary to distinguish the following diseases.

The urinary tract of renal tuberculosis genital tuberculosis concomitant with, it is the most common extrapulmonary tuberculosis, multiple blood infection, acute fever (fever), night sweats, fatigue, back pain, frequent urination, urgency, dysuria, hematuria and other symptoms, about 20% of the cases without clinical manifestations, also known as silent disease a few years later, renal failure, tuberculosis granuloma, caseous first involving the medulla, papillary region, and the nipple necrosis, renal pelvis deformation, cortical thinning, even involving the renal tissue around late, impaired renal function, bladder contracture. The lung X-ray examination, the prostate gland, the epididymis, the pelvic cavity tuberculosis examination, is helpful in this disease diagnosis. Urine hematuria (hematuria and hematuria, pyuria), positive skin test (PPD), urinary tuberculosis culture, the detection rate of more than 90%, while intravenous pyelography can only detect the advanced cases in recent years, poly ELISA (PCR) DNA detection of Mycobacterium tuberculosis have urine widely used in the diagnosis, the specificity, the positive rate of up to 95%.

Chronic glomerulonephritis is not difficult if it is swollen and has a large amount of proteinuria. The uric protein content of pyelonephritis basically is in 1 ~ 2g/d below, if be more than 3G, it is glomerulus pathological changes more. However, it is difficult to distinguish between the disease and latent nephritis. In the latter, there are more red blood cells in the urine routine, while pyelonephritis is mainly white blood cells. In addition, urine culture, long-term observation of patients with low fever, frequent urination and other symptoms, but also help identify. Secondary nephritis secondary urinary tract infection is difficult to identify, at this time a detailed history, combined with clinical characteristics to be analyzed.

Prostatitis is 50 years old of above male, because have prostate hyperplasia, hypertrophy, put urethral catheter, cystoscope to wait to be able to get this disease easily. Acute prostatitis except fever chills, white blood cell count increased, lumbosacral and perineal pain, that stand uneasy, frequent urination, dysuria, urine examination of pus cells, easily confused with acute cystitis. In addition to chronic prostatitis abnormal urine outside clinical symptom is not obvious. Prostate massage gets prostate fluid examination, leucocyte number >10 /HP, prostate B exceeds the examination to be helpful for differential diagnosis.

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