PYONEPHROSIS
It is collection of pus in pelvicalyceal system, which is converted into a multiloculated sac. Pyonephrosis is a term given to an infection of the kidney with pus in the upper collecting system which can progress to obstruction.
CAUSES :
- Infection of pre-existing hydronephrosis.
- Following acute pyelonephritis.
- As a complication of renal calculus—either stone in the renal pelvis or staghorn calculus.
CLINICAL FEATURES:
- Usually unilateral.
- Triad - Anaemia - Fever - Loin swelling
- Tender mass in the loin which is smooth, soft, not mobile, not moving with respiration.
- Cystitis
- Pyuria
- burning micturition.
- Features of toxicity such as fever with chills and rigors.
INVESTIGATIONS
- Plain X-ray
- KUB
- IVU
- Cystoscopy reveals cystitis with efflux of purulent pus through the ureteric orifice.
- USG - shows dilatation.
- DTPA scan
- CT SCAN
- MRI
COMPLICATIONS
- sepsis
- xanthogranulomatous pyelonephritis
- renal abscess
- perinephric abscess
- fistula to pleura, colon and duodenum
HOMOEOPATHIC MANAGEMENT:
- HEPAR SULPH
- MER SOL
- SILICEA
- ARSENIC
- CANTHARIS
- APIS