Urinary Tract Infections
(inc. cystitis, pyelonephritis)
Definition
Symptoms
- frequency
- urgency
- dysuria
- nocturia
- haematuria
- small volume voiding
- suprapubic / lower abdominal pain
- fever - if present may indicate solid organ involvement so manage
aggressively
- septic shock
Very different presentation in children
Source
- ascending infection
- haematogenous
- lymphatic
Associated factors
- indwelling catheters
- urolithiasis
- impaired bladder function
- bladder outlet obstruction
- vesicoureteral reflux
Organisms
- gram negative enteric bacteria
- E. coli (85%
community acquired infections)
- Enterobacter
- Proteus - leads to staghorn calculi
- Klebsiella - associated with stone, indwelling catheters
- Pseudomonas
- Enterococcus
- Gram positive organisms
- Atypical
Management (uncomplicated)
- history
- examination
- urinalysis
- culture
Differential diagnosis
- sexually transmitted diseases
- vaginitis
- trauma / sexual abuse
- urothelial tumor
- retained foreign bodies
- overactive bladder
Treatment (3-7 days)
Recurrent infections
- causes
- drug resistance
- reinfection
- bacterial persistence
- underdosing
- non-compliance
- Image to ensure no other complicating pathology
Complicated urinary tract infections
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