Inflammatory pathologies of the upper kidney are found even in the smallest patients. The course of pyelonephritis in a newborn child is quite severe and requires careful monitoring. Late diagnosis and improperly selected treatment contribute to the transition of the disease into a chronic form.
What it is?
Pyelonephritis is a disease in which renal excretory function is impaired. This pathology can develop at any age: both in infants and in adults and adolescents. In very young babies, pyelonephritis often occurs in conjunction with cystitis, which gave doctors the reason to use the term "urinary tract infection". The use of this term is not recognized by all specialists, however, it still exists in pediatric urological practice.
With pyelonephritis in babies the calyx-pelvic system and the adjacent areas of the renal tissue are damaged. The renal pelvis are structural structures in the kidney that are necessary for the accumulation and further drainage of produced urine. Normally, they look like a funnel. With pyelonephritis, the renal pelvis change their original shape and become very dilated.
According to statistics, the registered forms of pyelonephritis begin to be registered in babies already at the age of 6 months. Earlier cases of the disease are extremely rare, so they are considered statistically insignificant. Girls suffer from pyelonephritis more often than boys. This feature is due to the presence of a shorter urethra in them, which contributes to a more intense spread of infection.
Causes
Inflammation in the kidneys in babies can be caused by a variety of causative factors. If the cause of pyelonephritis is reliably established, then this form of the disease is called secondary, that is, developed as a result of some specific action of external or internal causes. To eliminate unfavorable symptoms in this case, first the treatment of the underlying pathology is required.
Primary pyelonephritis is a pathological condition that occurs for an unknown reason. Such forms are found in every tenth baby. Treatment of primary pyelonephritis is symptomatic.
To normalize the well-being of the child, various medications are used, which are prescribed in a complex manner.
Secondary pyelonephritis can be caused by:
- Viral infections. The culprits of the disease are quite often adenoviruses, Coxsackie viruses, and also ECHO viruses. Pyelonephritis in this case occurs as a complication of a viral infection. The duration of the incubation period for such forms of disease is usually 3-5 days. In some cases, the disease may have a latent course and is not actively manifested.
- Bacterial infections. The most common pathogens include: staphylococci, streptococci, Escherichia coli, Toxoplasma, Ureaplasma, Pseudomonas aeruginosa and other anaerobes. The course of the disease in this case is quite severe and proceeds with severe symptoms of intoxication.
To eliminate adverse symptoms, the appointment of antibiotics with uroseptic effect is required.
- Congenital malformations... Pronounced anatomical defects in the structure of the kidneys and urinary tract contribute to the violation of the outflow of urine. The presence of various strictures (pathological narrowings) in the calyx-pelvic system causes a violation of the excretory function.
- Severe hypothermia. The cold reaction causes severe spasm of the blood vessels. This leads to a reduced blood supply to the kidney and disruption of its work.
- Chronic diseases of the gastrointestinal tract... The anatomical proximity of the kidneys to the abdominal organs determines their involvement in the process in various pathologies of the digestive system. Severe intestinal dysbiosis is often a provoking cause of impaired metabolism.
- Gynecological diseases (in girls). Congenital abnormalities of the genital organs in babies often cause an upward spread of infection. In this case, the bacterial flora can enter the kidneys by penetrating the genitourinary tract from the vagina.
Symptoms in children under one year old
Determining the clinical signs of pyelonephritis in infants is a rather difficult task. Often it can occur in children in a latent or latent form. Usually, such a clinical variant of the disease is detected only during laboratory tests.
If the disease proceeds with the development of symptoms, then pyelonephritis in a child can be suspected by certain signs. These include:
- Fever onset. The body temperature of a sick child rises to 38-39 degrees. Against the background of such a fever, the baby develops a chill, and intoxication increases. The increased temperature persists for 3-5 days from the onset of the disease. It usually increases in the evening.
- Behavior change. The child becomes less active, sleepy. Many babies ask for more hands. Children of the first year of life in the acute period of the disease play less with toys, become more passive.
- Decreased appetite. The baby does not attach well to the mother's breast or completely refuses breastfeeding. The long course of the disease leads to the fact that the child begins to gradually lose weight.
- Discoloration of the skin. They become pale, dry. Hands and feet may feel cold to the touch. The child may also feel chills.
- Frequent urination. In very young children, this sign can be traced during diaper changes. If the diaper needs to be replaced too often, then this indicates that the baby has a urinary disorder.
- Soreness when tapping in the lumbar region. Only a doctor can identify this symptom. This simple diagnostic test has been successfully used for quite a long time to detect pain in the projection of the kidneys. If a child has kidney inflammation, then during such a study, he will cry or quickly change his body position.
- Change in mood. A newborn child cannot tell his mother where his pain is. He shows all his complaints only by crying.
If the baby has painful sensations in the kidney area or discomfort when urinating, then he will become more moody and whiny. Any changes in the baby's behavior should alert the parents and serve as a reason to consult with the attending physician.
Diagnostics
When the first signs of illness appear, you should definitely show the baby to the doctor. You can first consult with the attending pediatrician who observes the baby. However, urologists are engaged in the problems of treatment and diagnosis of pyelonephritis and other kidney diseases. The opinion of this specialist will be decisive in drawing up the tactics of therapy, especially in the case of anatomical defects in the structure of the kidneys.
To establish a diagnosis first, a clinical examination of the baby is carried out, during which the doctor identifies all the specific symptoms of the disease. Then the doctor will recommend an examination scheme, which includes the mandatory performance of a general blood and urine test. These simple and informative tests are necessary to identify infectious forms of pyelonephritis.
So, with bacterial and viral kidney pathologies in the general blood test, peripheral leukocytosis appears - an increase in the number of leukocytes. ESR also increases, and normal indicators in the leukocyte formula change. In the general analysis of urine, the number of leukocytes also increases, the pH and color change, and in some cases the specific gravity. To establish the exact pathogen, urine culture is carried out with the obligatory determination of sensitivity to various antibacterial agents and phages.
For babies with pronounced signs of pyelonephritis, ultrasound examination of the kidneys is also performed. This method allows you to identify all the anatomical defects in the structure of the urinary organs in the child, as well as establish the correct diagnosis.
This study is safe and does not cause any pain in the baby. An ultrasound of the kidneys is prescribed on the recommendation of a pediatrician or pediatric urologist.
The use of other, more invasive diagnostic methods in infants is most often not used. They are quite painful and can cause numerous complications in the child. The need for them is very limited. After carrying out the entire complex of examinations and establishing an accurate diagnosis, the pediatric urologist prescribes the necessary therapy regimen for the sick child.
Treatment
The main goal of therapy is to prevent the transition of the process into a chronic course. Treat acute forms of pyelonephritis carefully enough. Only correctly selected therapy and regular monitoring of its effectiveness will lead to the complete recovery of the baby from the disease. Primary pyelonephritis with an unknown cause that causes them are treated symptomatically. For this, various medications are prescribed to eliminate the adverse symptoms of the disease.
For the treatment of pyelonephritis in the smallest patients, the following methods are used:
- Organization of the correct daily routine. Severe symptoms of intoxication lead to the fact that the baby constantly wants to sleep. Do not limit it to this. To restore immunity, the child needs both night and full day rest. During sleep, the baby gains strength to fight the disease.
- Breastfeeding on demand. It is very important that the baby during the illness receives all the necessary nutrients, which are fully contained in breast milk. To normalize the child's drinking regime, it is necessary to additionally drink boiled water cooled to a comfortable temperature.
For babies receiving complementary foods, various fruit juices and compotes, previously diluted with water, are suitable as drinks.
- Medication therapy. It is prescribed only by the attending physician. For infectious forms of pyelonephritis, various combinations of antibiotics with a wide spectrum of action are used. Some of the antibacterial drugs, especially the older generations, have nephrotoxic properties (damage the kidney tissue).
Self-administration of antibacterial agents for the treatment of pyelonephritis in newborns and infants is unacceptable.
- Phytotherapy. It is used in babies older than 6-8 months. Lingonberry and cranberry are used as uroseptic medicinal plants. They can be used in various fruit drinks and compotes. These natural medicines have excellent anti-inflammatory properties and can improve kidney function.
- Vitamin therapy. It is especially effective in babies with congenital immunodeficiency conditions. Adding additional vitamins to the child's diet strengthens the immune system and helps to restore the baby's health faster.
Effects
Most cases of pyelonephritis in babies proceed without significant complications. However, under certain circumstances, the disease becomes chronic. This is largely due to improperly selected therapy for the disease or the presence of chronic pathologies in the child, which can worsen the prognosis of the course of the disease.
Bacterial forms of pyelonephritis in infants require more careful monitoring. In severe cases, they can cause various dangerous complications - abscesses and suppuration of renal tissue. These conditions lead to a pronounced deterioration in the condition and require emergency hospitalization of the baby in a hospital for emergency treatment.
Premature and weakened babies can tolerate pyelonephritis quite hard. With severe immunodeficiency, they may develop bacterial sepsis - a massive spread of infection from the kidneys throughout the child's body. This condition has an extremely poor prognosis. Treatment of bacterial sepsis is carried out in the intensive care unit.
Prevention
The body of a newborn baby is very sensitive to various infections that can get into it from the outside. In order to avoid dangerous kidney diseases, it is very important to comply with all sanitary and hygienic rules. When walking outside with your child, try to choose clothes for the weather. It should be comfortable enough and not cause hypothermia or overheating in the baby.
Preserving breastfeeding - very important for the correct functioning of children's immunity. This helps the child receive all the nutrients and vitamins necessary for his growth and development. The protective immunoglobulins contained in breast milk protect the baby's body from various infections and improve the indicators of his immunity.
If a child has congenital anomalies in the structure of the urinary system and kidneys, then from the very first months of life he must be observed by a urologist. Such children undergo general clinical blood and urine tests. Such control helps to prevent the chronization of the process and the dangerous consequences of pyelonephritis in later life.
All about the analysis of urine and the features of the treatment of urinary tract infections in children, see the following video.
