Urinary Tract Infections

 Urinary Tract Infections

Is an infection of the urinary tract and is subdivided into 2 general anatomic categories

Lower UTI – Cystitis and urethritis

Upper UTI – Perinephric and intrarenal abscess, acute pyelonephritis and prostatitis

Can be Acute or Chronic

Acute UTIs

Sub divided into Community acquired Acute UTIs and Nosocomial Acute UTIs

More common in women due to the short urethra

Etiology – E. coli most common cause.

Presentation is generally with urinary symptoms such as dysuria, frequency, urgency, hematuria and extra urinary symptoms like fever, lower abdominal pain, flank pain, nausea, vomiting, chills and rigors. May even have diarrhea

Diagnosis – Culture of urine gold standard but can also use urine analysis.

Urine culture – growth of >100,000 colony forming units of bacteria

Urine analysis – detection of WBCs (>5 in centrifuged, >10 in unspun specimen)

Supportive labs – Raised WBC in peripheral blood

Treatment

Remove risk factors – catheter, stones, etc

Treat the infection with antibiotics

Uncomplicated – Oral antibiotics – Amoxicillin, Norfloxacin, Ciprofloxacin, Cefalexin

Complicated – IV antibiotics – Ceftriaxone, Ciprofloxacin

Supportive management – antipyretics, anti-pain, anti-emetic, fluid resuscitation

Reference

Harrisons Textbook of Internal Medicine

Internal Medicine: Just the facts

Pocket Medicine, 4ed