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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