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UrinaryTract Infection (UTI)


Pathology:                     UTIs are bacterial or fungal infections of the urinary tract which are more common in women due to their shorter urethra which is in closer proximity to the anus.


Aetiology:                     The most common causes of UTIs include; E. Coli, Proteus, Pseudomonas, Klebsiella and Enterococcus.


Symptoms:                   In the case of a simple UTI, symptoms may include; frequency, urgency, dysuria, nocturia, and haematuria, whereas in pyelonephritis, additional symptoms may include; loin pain, fever, rigors, vomiting and frequency.


Signs:                               In a UTI, signs may involve supra-pubic tenderness, whereas in the case of pyelonephritis, signs may include; renal angle tenderness and a fever.


Investigations:           Blood tests such as an FBC, CRP, U&E and blood cultures may be conducted if the patient is feeling unwell, as well as a urine dipstick and MC&S and a KUB X-ray to rule out stone disease.


Treatment:                   A conservative approach to treatment may involve increasing fluid intake, double voiding, voiding after intercourse, and hygiene advice. Antibiotics such as Trimethoprim, amoxicillin, nitrofurantoin may be prescribed, and if the patient is systemically unwell, gentamicin may be administered intravenously.


Complications:         Complications of UTIs may include urosepsis, renal abscess, and renal papillary necrosis.


Prognosis:                     For the majority of cases a full recovery can be expected in a rapid fashion.


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