Fever with frequent urination, urgency, dysuria, back pain

Introduction Urinary urgency means that you can't control your urination. If you want to urinate, you need to urinate. After urinating, you have urinary urgency. You need to urinate urgently. If you don't urinate in time, you will wet your underwear. Mainly due to urinary tract, bladder, prostate caused by inflammation or foreign body stimulation, often accompanied by dysuria. Fever with frequent urination, urgency, dysuria, and back pain are symptoms of frequent urination, urgency, dysuria, and back pain caused by urinary infection.

Cause

Common in urinary tract infections, pay attention to the presence or absence of diabetes, renal trauma, urological surgery and device examination history, with or without colitis or constipation. Women pay attention to pregnancy and birth history, incidence and pregnancy, menstruation, and gynecological diseases such as pelvic inflammatory disease.

an examination

Related inspection

Regression of Treponema pallidum (BR) Prostate-specific antigen basal metabolic acid phosphatase monocyte ratio (MONO%)

Diagnostic check:

1. In addition to general urine routine examination, urinary sediment smear Gram stain for bacterial examination, if necessary, 1h urine cell discharge rate determination (method: emptying the bladder, collecting 3h clean urine, calculate 1h urine white blood cells and non-squamous The number of epithelial cells. Judgment: 300,000 has diagnostic significance). This method is more accurate than the 12h urine sediment counting method.

2. Clean mid-stage urinary bacteria culture, colony count and drug sensitivity determination, Gram-negative bacilli colony count 100,000 / ml have diagnostic significance, 10,000 ~ 100,000 / m1 is suspicious, 10,000 / ml are there Diagnostic significance. Infection should be considered when the Gram-positive cocci colony count is 100-10000/ml.

3. Special cultivation and inspection. For conventional bacterial and fungal cultures, when pathogenic bacteria are not found, hypertonic culture (0.3M sucrose medium) can be used to exclude L-type bacterial infection, and anaerobic culture is used to exclude anaerobic infection. Check for viruses, mycoplasmas, and saprophytic parasites when necessary.

4. Renal function test includes glomerular filtration rate measurement, renal tubular concentrating function, acidification function test, chronic cases should be checked for blood and urine potassium, sodium, chlorine, calcium, phosphorus, magnesium, pH, arterial blood gas analysis.

5. Repeated episodes of routine double-B-ultrasound examination, as appropriate for intravenous pyelography or retrograde urography, if necessary, CT examination. Women should undergo gynecological examinations and pelvic venography should be performed if necessary to exclude the presence of predisposing factors.

6. Diagnostic criteria are often divided into upper and lower urinary tract infections according to the location of urinary tract infection. Upper urinary tract infection refers to pyelonephritis, which can be divided into acute and chronic pyelonephritis according to clinical features. Pyelonephritis may be associated with a lower urinary tract infection, while lower urinary tract infections are often present separately.

Differential diagnosis

(1) fever with chills

Common in lobar pneumonia, sepsis, acute cholecystitis, acute pyelonephritis, epidemic cerebrospinal meningitis, leptospirosis, malaria, acute hemolytic disease.

(2) fever with eye congestion

Common in measles, epidemic hemorrhagic fever, typhus, etc., similar to rabbit eye performance.

(3) fever with bleeding

Common in severe infections and blood diseases. The former such as severe measles, epidemic hemorrhagic fever, dengue fever, viral hepatitis, typhus, sepsis, infective endocarditis, leptospirosis. The latter are acute leukemia, acute aplastic anemia, malignant histiocytosis.

(4) fever with lymphadenopathy, accompanied by tenderness

May be caused by a local infection. Such as systemic lymphadenopathy, suggesting that there may be lymph node tuberculosis, leukemia, lymphoma, metastatic cancer.

(5) fever with joint swelling and pain

Can be seen in sepsis, scarlet fever, brucellosis, tuberculosis, rheumatic fever, connective tissue disease, gout and so on.

(6) fever accompanied by rash

Common in rash infections. Such as measles, scarlet fever, etc.

(7) fever with cough, sputum, chest pain

Common in respiratory diseases.

(8) fever accompanied by abdominal pain, diarrhea, nausea, vomiting

Common in digestive disorders.

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