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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