Epistemology (pustular) jade

Epistemology jade is a purulent metastatic kidney disease, the initial focus of which are purulent processes in other organs - felon, furuncle, mastitis, purulent otitis, sinusitis, and other, often ended by the time the kidney symptoms.
Pathogenic microorganisms (staphylococci, rarely streptococci - hematogenous route fall into the cortical layer of the kidneys in the form of infectious emboli, stuck in the glomeruli and small end vessels. Endothelium glomeruli swells, white blood cells accumulate in the capillaries. Formed by multiple small abscesses, size pinhead to pea, located mainly in the thickness of the cortical layer and especially on the surface of the kidney, peaking through the fibrous capsule.
Sometimes small abscesses merge together to form an abscess kidneys.
The process can be one - or two-way.
The external inspection kidney increased in volume, blue-purple color, its surface is covered with multiple small abscesses, which are especially visible after removal of the fibrous capsule.
The disease is acute. Suddenly complete well-being among the temperature rises up to 39-40°, accompanied by spectacular chills; with short-term reduction it is profuse sweating. General malaise, loss of appetite, nausea, sometimes vomiting, istericeski sclera, dry tongue testify to the septic nature of the disease.
Urine contains lack of white blood cells, or they are absent at all. The number of leukocytes in the blood sharply increased, it may be higher in the blood taken from the lumbar region affected side than in the blood taken from a finger. When bilateral aposematism nephritis the level of residual nitrogen and indican blood.
If chromolithography the affected kidney allocates Indigo Carmine very late.
Review on an x-ray picture is observed reactive effusion of fluid in the pleural sinus and high standing of the diaphragm with a sore hand. When x-rays of the chest - the decreased mobility of the diaphragm on the affected side.
The diagnosis is easier to identify in the near history of purulent diseases.
With the protracted period of pyelonephritis can be a source of hematogenous infection of the kidney and go in epistemology jade.
Treatment pustular jade begins with the application of massive doses of antibiotics. Small abscesses under the influence of antibiotics can disappear.
If antibiotic treatment does not improve the General condition and the normalization of temperature, do not wait a long time with surgery. Reveal one or both kidneys and remove the fibrous capsule (decapsulate kidney). However, many small abscesses burst spontaneously, remaining open with a scalpel. If there is a stagnation of urine in the sack, it injected drainage through the renal parenchyma or through the exposed pelvis. Drainage perinephral fiber is achieved by obkladyvanii kidney 3-4 gauze swab and the tabulation of rubber drainage. The wound edges closer rare silk sutures.