Medicine
/
Infection

Infection

UrinaryTract Infection (UTI)

 

Pathology:                    Bacterial or fungal infectionof the urinary tract.

                                          Morecommon in women due to shorter urethra and proximity to anus

 

Aetiology:                     Commonorganisms: E. Coli, Proteus, Pseudomonas,Klebsiella and Enterococcus

 

Symptoms:                   Simple UTI: Frequency, urgency dysuria,nocturia, haematuria

                                          Pyelonephritis:Loin pain, fever,rigors, vomiting and frequency

 

Signs:                              Simple UTI: Supra-pubic tenderness

                                          Pyelonephritis: Renal angle tenderness, fever

 

Investigations:          Bloods: FBC, CRP, U&E and bloodcultures if systemically unwell

MSU: Urine dipstick and MC&S

Imaging: KUB X-ray to rule out stone disease

 

Treatment:                  Conservative Management: Increase fluidintake, encourage double voiding,

voiding after intercourse and hygiene advice

Antibiotics - If prescribing empiricalantibiotics ensure sensitivities are checked

Trimethoprim, amoxicillin and nitrofurantoincommonly used.

If systemically unwell considerIV gentamicin

 

Complications:         Urosepsis, renal abscess, renalpapillary necrosis

 

Prognosis:                    Normallya full and rapid recovery occurs.

 

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