This case study delves on Nephrolithiasis with UTI complicated and its physiopathology. It also aims to present baseline information on the proper prognosis, treatment options and measures to prevent such occurrence.
Nephrolithiasis refers to the condition of having kidney stones. Having kidney stones are one of the most common urological problems. As stone grow on the surfaces of the renal papillae or within the collecting system, the need not produce symptoms. Asymptomatic Stones may be discovered during the course of radiographic studies. Stones become symptomatic when they enter the ureter causing pain and obstruction.
The case of patient R.R she was of the flank pain on the left side associated with dysturia and hematuria. After urinalysis the diagnosis revealed UTI complicated with Nephrolithiasis. Differential diagnosis in this case however a secondary cause of UTI must be ruled out such as hematuria coming from patient with urinary tract obstruction which also manifest with pyuria and dysuria can be ruled out since the patient does not have azotemia, oliguria, anuria and full bladder after avoiding.
Most patient with nephrolithiasis have remediable metabolic disorders that cause stones and can be detected by chemical analyses of serum and urine. A practical outpatient evaluation consist of two 24 hours urine collections with corresponding blood sample, measurements of serum and urine calcium, uric acid, electrolytes, and creatinine, and urine PH, volume, oxalate,citrate should be made.
Since stone risks vary with diet, activity, and environment, at least one urine collection should be made on a weekend when the patient is at home and another on a work day. However, no matter what disorders are found, every patient should be counseled to avoid dehydration and to drink copious amount of water. The efficacy of high fluid intake was confirmed in a study of first time stone formers.
Complicated UTI may not necessarily caused by the onset of Nephrolithiasis but the treatment of the latter is corollary to the treatment of the other. However, UTI may recur for some other complications caused by other infections.
The case presented was a clear example of a well managed medical case, diagnosis was made after all the needed laboratories and proper management was administered for appropriate treatment.
With proper management and medication, patients with Neprolithiasis can readily recover from such illness especially if there is a strong lifeline support from the family with the guidance of medical practitioners.