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COXDOX: VXILATERAL IXFECTIOX OP KIDXEY. [New York Medical Journal, localized tenderness over the kidney. I decided Buy Aciclovir Online on M.iy 4th to make an exploratory operation, and then removed the kidney, which was increased to twice its normal size. There was a moderate degree of inflammation in the pel- vis, but no retention. On section, the kidney tissue showed a number of small abscesses disseminated throughout its substance. The patient made a complete recovery, and has never since had any renal trouble. The first case Aciclovir 5 Cream belongs to that fulininatiii;:; tvpe of infection which demands early and radical oper- ative treatment. I am con\inced that this jjaticnt would have died had she not been operated upon, though possibly not so soon. I believe that if she had been o])erated upon during the first twenty-four hours after the beginning of her trouble, she would have lived. It was one of those cases, like some of appendicitis and of acute osteomyelitis, of the most virulent intoxication, in which time is m' important an element. The second case illustrates that tvpe in wliicli the infection is milder. Just what the final outcomv would have been without Buy Aciclovir an operation we cannot say. I believe, however, her symptoms would have gone on. gradually growing worse, the Buy Aciclovir Tablets Uk Aciclovir Cream Bp ab-cesses in the kidney coalescing and destroying it, unless death came sooner from sepsis. This form of kidney infection is hematogenous in origin, occurring u-ual!y Aciclovir Eye Ointment in persons apparently in normal health, ^^'omen are more likelv to be attacked than men. as pregnancy predisposes them. The increased congestion of the kidney, on account of the pressure on the renal vessels by the gravid uterus, i- no doubt a cause. The right kidnev is more often affected than the left, the reason for which I believe is that it is more often Aciclovir Buy displaced, and therefore more liable to passive congestion. This also explains the unilateral involvement. It may arise during the cour-e of ?ome other infection in the body, such as erysipelas, endocarditis, influenza, Aciclovir Tablets 800mg scarlet fever, typhoid fever, pneumonia, and osteo- myelitis. In fact, in anv itifective process the or- ganisms may be secondarily deposited in the kidney. This form of renal infection is distinct from that class of renal abscesses due to an ascending infe"- tion. Some of the acknowledged authorities in renal diseases, among them Guyon and Albarran, are of the Buy Aciclovir Tablets opinion that Aciclovir Cold Sore many of the kidney infections, secondary to bladder troubles, are also hemato- genous in origin. The kidney is the most vascular organ in the body. Landergren has observed that, under the action of strong diuretics, the amount of blood which passes through the kidney in a min- ute'~ time equals its weight. On account of its ex- Aciclovir Tablets 200mg treme vascularity, a passive congestion is easily produced, and this is the most frequent predispos- ing cause of infection. Normally the kidney ex- crete= various microorganisms without injurv tn its substance. It is not unusual to find the colon bacillus, and in typhoid fever and tuberculosis the organisms causing these di-eases are often thrown oft in the urine without any involvement of the kidnev structure. The organisms causing this form of infection belong to the pus organisms, and the mo~t frequent is the colon bacillus. I am con- vinced that we never have an infection in the kid- ney without some previou- change in the renal cir- culation or a physiological or pathological disturb- ance in the kidne\' itself. These changes mav be so slight that the jjatient's attention may never have been directed to the kidney, but are suflficient to cause a lowered resistance in the Aciclovir Tablets To Buy organ, and thus .give rise to a suitable soil for infection. The symptoms of unilateral septic infection of the kidney appear suddenly. There is pain over the affected organ, extending around the upper part of the abdomen, and this is ^evere and continuous. It is that kind of pain described as intrarcnal, in contradistinction Aciclovir 800mg to extrarenal pain or colic, which is intermittent or paroxysmal and produced by changes in the ureter or pelvis. The pain of septic infection appears sometimes so suddenly and is so intense that the condition has been mistaken for a visceral perforation or fulminating Aciclovir Dispersible Tablets appendicitis. In this form of infection there is always marked tenderness over the kidney, and this is so apparent that the slightest pressure is complained of, and it Aciclovir Bp is greatly intensified by fist percussion. The point of greatest tenderness is at the costovertebral angle. There is hyperesthesia of the skin over the kidney Where To Buy Aciclovir and ridigity of the lumbar muscles. There is usually vomiting, fever, rapid pulse, prostration, and a high Aciclovir Tablets Buy Online leucocytosis. The fever is continuous and of a typhoid character. There are usually chills and sweating. The patient affected with thi~ malady impresses one as being very ill. The urinary findings vary : in fact, pathological findings may be absent. There is, however, usually some pus, albumin, and microscopic blood. In two of Cobb's seven cases the urinary findings were negative. One would naturally expect, with such marked general symptoms, to find a great deal of disturbance in the renal secretion, but this is not the case. The finding of pus, blood, and albumin aids one in the diagnosis, but their absence should not deter us from making this diagnosis if the general symjitoms point to a kidney infection. A cystoscopic examination, together with ureteral Valaciclovir Vs Aciclovir catheterism. should be made. If there are albumin and pus, one will be able to tell from which kidney it comes, and also to determine the presence of the other kidney and its Aciclovir Cold Sore Cream functional capacity. To differentiate this form of renal infection from acute abdominal conditions with similar symptom^ is not always an easy matter. The suddenness of onset without a previous history of urinary trouble, the location and kind of pain, the great

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