Urinary Tract Infection Flashcards
What is infection of the epididymis/testis called?
Epididymo-orchitis
What is the most common type of hospital acquired infection?
UTI
What are the general predisposing factors which make an individual more susceptible to UTI?
Immunosuppression
Steroids
Malnutrition
Diabetes
Female sex (short urethra)
Sexual intercourse and poor voiding habits
Congenital abnormalities e.g. duplex kidney
Stasis of urine e.g. due to poor bladder emptying
Foreign bodies eg catheters, stones
Oestrogen deficiency in postmenopausal women
Fistula between bladder & bowel
Name three organisms capable of causing a UTI
E.Coli
Klebsiella species
Enterococci
Proteus mirabilis
What is the possible consequence of ascension of UTI?
Pyelonephritis and acute kidney injury
What are the clinical features of UTI in children?
–Diarrhoea
–Excessive crying
–Fever
–Nausea and vomiting
–Not eating
What are the clinical features of UTI in adults?
–Flank pain
–Dysuria (“like passing broken glass”)
–Cloudy offensive urine
–Urgency
–Chills
–Strangury - feeling if having not voided even though they have
–Confusion (very old people)
What are the clinical features of acute pyelonephritis?
- Pyrexia
- Poor localisation
- Loin tenderness (renal angle)
- Signs of dehydration
- Turbid urine
What are the investigations for UTI?
MSSU
•Urinalysis In ward
–Blood,
–leucocytes,
–protein and
–nitrites
•Microbiology In laboratory
–Microscopy and Gram staining
–Bacteruria >105 CFU /ml
Culture and sensitivity
What are the relevant investigations for children, men or when UTIs are frequent?
–Ultrasound or IVU may be helpful
–Isotope studies to rule our reflux and scarring
What are the principles of management of UTI?
1 Identify the infecting organism & institute appropriate treatment
2 Identify predisposing factors and treat if possible
What is the treatment of UTI?
- Fluids
- Antibiotics
Amoxicillin (3-5 day course or 3g x 2), cephalosporin
Trimethoprim
Severe infections
Intravenous antibiotics
When is renal impairment likely to occur after a urinary tract infection?
If the urinary tract is functionally normal (on imaging) - repeated / persistent UTI’s seldom result in renal damage
If there is anotomical / neurological abnormalities / stones / diabetes - may cause infections and sometimes lead to renal impairment
What is a congenital cause of UTI’s in children?
Reflux and infection
What is the relevant investigation for reflux nephropathy?
Micturating cystogram (radionuclide 99 Tc techniques)
Assessment of pregression by ultrasound scan and biochemistry
What are the radiological findings of chronic pyelonephritis?
Scarring and clubbing
