Patterson J E, Andriole V T
Department of Medicine (Infectious Diseases), University of Texas Health Science Center at San Antonio, USA.
Infect Dis Clin North Am. 1997 Sep;11(3):735-50. doi: 10.1016/s0891-5520(05)70383-4.
Diabetes mellitus has a number of long-term effects on the genitourinary system. These effects predispose to bacterial urinary tract infections in the patient with diabetes mellitus. Bacteriuria is more common in diabetic women than in nondiabetic women because of a combination of host and local risk factors. Upper tract infection complications are also more common in this group. Diabetic patients are at higher risk for intrarenal abscess, with a spectrum of disease ranging from acute focal bacterial pyelonephritis to renal corticomedullary abscess, to the renal carbuncle. A number of uncommon complicated urinary tract infection complications occur more frequently in diabetics, such as emphysematous pyelonephritis and emphysematous pyelitis. Because of the frequency and severity of urinary tract infection in diabetic patients, prompt diagnosis and early therapy is warranted. A plain abdominal radiograph is recommended as a minimum radiographic screening tool in the patient with diabetes presenting with systemic signs of urinary tract infection. Ultrasonography or further radiographic studies such as CT scanning may also be warranted, depending on the clinical picture, to identify upper urinary tract complications early for appropriate intervention.
糖尿病对泌尿生殖系统有许多长期影响。这些影响使糖尿病患者易患细菌性尿路感染。由于宿主和局部危险因素的综合作用，菌尿在糖尿病女性中比非糖尿病女性更常见。上尿路感染并发症在该群体中也更常见。糖尿病患者发生肾内脓肿的风险更高，疾病范围从急性局灶性细菌性肾盂肾炎到肾皮质髓质脓肿，再到肾痈。一些不常见的复杂性尿路感染并发症在糖尿病患者中更频繁发生，如气肿性肾盂肾炎和气肿性肾盂炎。由于糖尿病患者尿路感染的频率和严重程度，需要及时诊断和早期治疗。对于出现尿路感染全身症状的糖尿病患者，建议至少进行腹部平片作为影像学筛查工具。根据临床表现，可能还需要超声检查或进一步的影像学检查，如CT扫描，以便早期识别上尿路感染并发症，进行适当干预。
