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临床上急性肾盂肾炎的诊断,首先依据尿路感染症状,腰痛、发热及尿常规炎性变化,经中段尿培养、膀胱穿刺尿液培养或导尿培养捡出细菌而获得诊断。本文报告一组无尿路症状的急性肾盂肾炎并对其特点加以初步总结。 1 临床资料 1.1 一般资料 1992年2月—1995年1月治疗细菌兼L型败血症41例。符合无尿路症状急性肾盂肾炎16例,男9例,女7例;年龄16～65岁;病程3～15d。 1.2 临床表现 全组全系发热入院,不规则发热10例,弛张热4例,低热2例,体温在38.0～40.0℃。伴有原发病表现,如:扁桃体炎、胆囊炎、皮肤疖肿、副鼻窦炎等,3例起因不明。体征:2例猩红热样疹,10例局部淋巴结肿大,肺呼吸音粗糙7例,脾大3例,肝大1例,白细胞3.0～11.2×10~9/L,其中:<4.0×10~9/L 5例,4.1～10.0×10~9/L 9例,>10.0×10~9/L 2例。血片分类表现不同程度中性粒细胞增多、核左移、浆中出现较多空泡及中毒颗粒。胸片有3例双肺中下有间质肺炎改变。16例血培养,中段尿培养全部获葡萄球菌、凝固酶阳性,L型者凝固酶多阴性,并进行纸片法药敏。
Clinical diagnosis of acute pyelonephritis, first of all based on the symptoms of urinary tract infection, back pain, fever and urinary routine inflammatory changes, by the middle of urine culture, bladder puncture urine culture or catheterization culture bacteria were diagnosed. This article reports a group of no acute urinary tract symptoms of pyelonephritis and its characteristics to be initially summarized. 1 Clinical data 1.1 General Information February 1992-January 1995 treatment of bacteria and L-type sepsis in 41 cases. In line with no urinary tract symptoms of acute pyelonephritis 16 cases, 9 males and 7 females; aged 16 to 65 years; duration of 3 ~ 15d. 1.2 clinical manifestations of the whole group of patients admitted to the hospital, irregular fever in 10 cases, 4 cases of fever, fever in 2 cases, body temperature at 38.0 ~ 40.0 ℃. Accompanied by the performance of the original disease, such as: tonsillitis, cholecystitis, skin boil, sinusitis, etc., 3 cases of unknown cause. Signs: 2 cases of scarlet fever rash, 10 cases of local lymph nodes, lung breath sounds rough in 7 cases, 3 cases of splenomegaly, liver 1 case, white blood cells 3.0 ~ 11.2 × 10 ~ 9 / L, There were 9 cases of 9 / L, 9 cases of 4.1 ~ 10.0 × 10 ~ 9 / L and> 10.0 × 10 ~ 9 / L of 2 cases. Blood film classification showed varying degrees of neutrophils, nuclear left shift, there are more vacuoles and poisoning particles in the pulp. Chest radiography in 3 cases of pneumonia in the middle and lower lung changes. 16 cases of blood culture, the middle urine culture were all staphylococcus, coagulase-positive, L-type coagulase and more negative, and paper method drug sensitivity.