Lecture 27 Urinary Tract Infection Flashcards
What is a UTI in the kidney called
Acute/Chronic Pyelonephritis
What is a UTI in the bladder called
Cystitis
What is a UTI in the urethra called
Urethritis
What is a UTI in the prostate called
Prostatitis
What is a UTI in the Epididymis//Testis called
Epididymo-orchitis
Name general factors that make an individual more susceptible to UTI
Immunosuppression
Steroids
Malnutrition
Diabetes
Name Predisposing Factors Specific to the Urinary Tract
o Female sex (short urethra)
o Sexual intercourse and poor voiding habits
o Congenital abnormalities e.g. duplex kidney
o Stasis of urine e.g. due to poor bladder emptying
o Foreign bodies eg catheters, stones
o Oestrogen deficiency in postmenopausal women
o Fistula between bladder & bowel
What bowel organisms cause UTIs
– E coli, Proteus, Klebsiella, Enterococcus
Clinical features of UTIs in children
– Diarrhoea – Excessive crying – Fever – Nausea and vomiting – Not eating
Clinical features of UTIs in adults
– Flank pain – Dysuria (“like passing broken glass”) – Cloudy offensive urine – Urgency – Chills – Strangury – Confusion (very old people)
Clinical features of Acute Pyelonephritis
- Pyrexia
- Poor localisation
- Loin tenderness (renal angle)
- Signs of dehydration
- Turbid urine
Investigations carried out for suspected UTI
• Mid-stream sample of urine. • Urinalysis In ward – Blood, – leucocytes, – protein and – nitrites • Microbiology In laboratory – Microscopy and Gram staining – Bacteruria >105 CFU /ml • Culture and sensitivity
What investigations can be helpful in children, men or people with frequent UTIs
- Ultrasound or IVU may be helpful
* Isotope studies to rule our reflux and scarring
How are UTI’s treated
• Amoxicillin (3-5 day course or 3g x 2), cephalosporin
• Trimethoprim
Severe infections
• Intravenous antibiotics
Name clinical features of chronic pyelonephritis
- Radiological diagnosis
- Scarring & clubbing
- Hypertension / CRF
