Infections VI: Renal Infections

Question 1

Describe Lower UTIs (uncomplicated)

Answer 1

Causes = commonly bacteria in bladder/urethra (usually E.coli from GI tract)
Risk factors = female, sexual activity, pregnancy, diabetes
Symptoms = increased urgency, burning on urination (dysuria), cloudy or bloody urine

Question 2

How are UTIs tested for?

Answer 2

Dipstick
Urinalysis
Culture if required

Question 3

How are uncomplicated lower UTIs treated?

Answer 3

Short course nitrofurantoin or trimethoprim - 3 or maybe 7 days (for children as well)
Cephalosporins/penicillin in pregnancy

Question 4

How are recurrent UTIs treated?

Answer 4

May receive prophylactic (preventative) antibiotics e.g. trimethoprim/nitrofurantoin/ceflaxin
Low dose at night

Question 5

Describe Trimethoprim

Answer 5

Broad-spectrum - most UTI-causing bacteria
Inhibits folate synthesis
Rapidly absorbed with high bioavailability

Question 6

Describe Nitrofurantoin

Answer 6

Broad-spectrum
Bactericidal
Indicated only for UTIs
Interferes with bacterial proteins, DNA and cell wall via reactive intermediates = multiple sites of action
Highly soluble in urine, does not penetrate tissues

Question 7

What is a complicated UTI?

Answer 7

One that occurs due to a structural abnormality or blockage in the urinary system
or other underlying health condition

Question 8

What is the treatment for complicated UTIs?

Answer 8

Manage abnormality
Antimicrobial therapy (7-14 days fluoroquinine, cephalosporin)
Often require hospitalisation

Question 9

Describe Prostatitis (bacterial)

Answer 9

Inflammation of the prostate gland
Symptoms = pain or problems with urination/ejaculation, discomfort in pelvis/lower back/genitals - usually sudden with bacterial infection (acute)

Question 10

How is Prostatitis (bacteria) tested for?

Answer 10

Dipstick
Lab testing urine
Scans

Question 11

How is Prostatitis (bacterial) treated?

Answer 11

28 course of antibiotic

Ciprofloxacin 500mg BD or Orfloxacin 200mg BD

Question 12

Describe Pyelonephritis

Answer 12

Kidney infection - when a UTI progresses to the upper urinary system (kidneys and ureters)
Risk factors = women, obstructing or underlying abnormality, immunocompromised, pregnancy
Symptoms = high fever, increased heart rate, painful urination, nausea, flank pain, malaise

Question 13

How is Pyelonephritis treated?

Answer 13

Broad-spectrum cephalosporin or quinolone 10-14 days

Question 14

Describe Cystitis

Answer 14

Bladder infection

Symptoms = increased urgency and frequency, dysuria, bacteria and WBCs in urine