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