infection Flashcards
what is a lower UTI
confined to bladder
who usually gets UTIs
sexually active women + catheterised patients
what bacteria usually resides in urinary tract
all sterile apart from lower end of urethra (gut coliforms)
symptoms UTI
dysuria, frequency, smelling, abdo pain, low grade fever, eldery = confused
dipstick UTI findings
leukocytes or nitrite + RBC
what patients is dipstick UTI diagnosis not appropriate
women >65, men, catheterised patients
how is a urine sample collected for UTI + in what container
mid stream // boric acid keeps it for 24 hours // universal container –> lab within 2 hours
which patients should urine cultures be sent for
women >65, recurrent UTI, pregnant, men, haematuria
what bacteria usually causes UTI
Ecoli
what is urethral syndrome
abacterial UTI // early UTI, honeymoon cystitis, STI
mx for asymptomatic bacteriuria
none - unless pregnant (V common in catheterised patients)
1st line mx non-pregnant UTI
trimethroprim or nitro 3 days
mx UTI pregnant women
1 = nitrofuratonin (1+2 tri) // 2 = amox or ceflaxelin
when should trimethroprim be avoided in pregnancy
first semester teratogenic
mx asymptomatic bacteruria pregnant women
nitro, amox or ceflalexin 7 days
what follow up is needed after mx asymptomatic bacteruria pregnant women
–> urine culture to test of cure
men UTI mx
trimethroprim or nitro 7 days (no urology referral needed if uncomplicated)
mx catheter UTI
only treat if symptomatic // 7 day abx // change catheter
causes acute pyelonephritis
1 = E.coli // klebsiella, enterococcus // rare pseudomonas or proteus
symptoms acute pyelonephritis
fever, loin pain, N+V, history UTI
invx acute pyelonephritis
mid stream urine sample
mx acute pyelonephritis
cephalosporin eg ceftriaxone, cephalexin // quinolone eg ciprofloxacin // 7-10 days
symptoms proteus pyelonephritis
can cause kidney stones, burnt chocolate urine smell, swarn culture
mx pseudomonas acute pyelonephritis
cirpoflocaxin
what abx can be used 1st line for UTI
nitro, trimeth, amox, gent
what is Emphysematous pyelonephritis
necrotising infection of renal parenchyma
what usually causes Emphysematous pyelonephritis
gas forming eg e.coli or klebsiella
who can get Emphysematous pyelonephritis
diabetics, uteric obstruction
invx + mx Emphysematous pyelonephritis
CT –> nephrectomy
what cause prostatitis
E.coli via urethra –> prostate
RF prostatitis
UTI, urogenital instrument, bladder catheter, biopsy
symptoms prostatitis
referred, obstructive voiding, fever, PR = tender, boggy prostate
mx prostatitis
screen STI, cipro 14 days
what is Schistosomiasis
parasitic flatworm infection of bladder
acute symptoms Schistosomiasis
itch, fever, urticaria + angioedema, arthalgia or myalgia, cough, diarrhoa
bloods acute Schistosomiasis
eosinophilia
what is chronic Schistosomiasis
eggs in bladder –> obstruction + kidney damage
symptoms chronic Schistosomiasis
frequency, haematuria, bladder calcification on Xray
inxv Schistosomiasis
serum shistosome (asymptomatic) // gold standard = bladder or stool micropscopy
mx Schistosomiasis
single dose oral praziquantel
