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Phase identification. Abdominal pain, low back pain and obvious to cholecystitis, appendicitis , pelvic inflammatory disease , renal abscess and other identification , usually after repeated urine examination can confirm the diagnosis. Urinary tract symptoms of chronic pyelonephritis is not obvious , no significant change in urine or urine abnormalities intermittent , easily misdiagnosed . In women, who have unexplained fever , backache , fatigue , mild urinary tract symptoms without the possibility of this disease should be considered . Must repeatedly check the urine and culture and find evidence of chronic pyelonephritis with hypertension and hypertension need to be identified. Furthermore , following various diseases still need to be identified. ( A ) genital tract bleeding renal tuberculosis is often also associated with tuberculosis , which is the most common extrapulmonary tuberculosis, multi-line blood infections , acute phase with fever ( fever ) , night sweats , fatigue , back pain, urinary frequency, urgency , dysuria , urine and other symptoms, about 20% of cases can be no clinical manifestations, urinary tract infection , also known as the silent type , a few years after the destruction of the renal parenchyma , tuberculosis granuloma, caseous becomes the first involving the medulla, the nipple area , followed by papillary necrosis , renal pelvis light deformation, cortical thinning, even can affect the kidneys surrounding tissue , the latter with impaired renal function , bladder contracture. X -ray examination of the lungs , prostate, epididymis , pelvic tuberculosis detection can help diagnose the disease. Urine hematuria ( microscopic hematuria or gross hematuria ) , pyuria , positive skin test (PPD), urinary tuberculosis culture , the detection rate of over 90%, while intravenous urography can only be found in late stage cases in recent years, polymerase linking reaction (PCR) method to detect Mycobacterium tuberculosis DNA in urine has been widely used in the diagnosis , its specificity, positive rate of 95 %.
(B ) subject to chronic glomerulonephritis edema , proteinuria is identification difficult . Proteinuria pyelonephritis generally 1 ~ 2g / d or less , if more than 3g is mostly glomerular lesions . But the disease more difficult to identify with the occult nephritis , urine in the latter have more red blood cells, white blood cells and the main places of pyelonephritis . In addition, urine culture , long-term observation of patients with or without fever, frequent urination and other symptoms will also help identify. Late nephritis secondary to urinary tract infections, difficult to distinguish , this time a detailed medical history , clinical characteristics were analyzed.
( C) the prostate in men over the age of 50 due to benign prostatic hyperplasia , hypertrophy, urethral tube placement guide , cystoscopy and so easy to get the disease. In addition to acute prostatitis chills , fever, elevated white blood cell count , the lumbosacral and perineal pain, so that from the stand anxiety, frequent urination, painful urination , urine check pus , and acute cystitis easily confused . In addition to urine abnormalities chronic prostatitis clinical symptoms were not obvious . Get prostate massage prostate fluid examination , the white blood cell count > 10 / HP, B ahead of the gland can help in the differential diagnosis .
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