Urinary Tract Infection

Question 1

What are the names for inflammation of the urinary tract at its different sections?

Answer 1

Pyelonephritis : kidney inflammation

Ureteritis

Cystitis - bladder inflammation

Urethritis
Prostatitis

Question 2

What are some general factors that predispose an individual to UTI?

Answer 2

Immunosuppression
Steroids
Malnutrition
Diabetes
Stones
Bladder obstruction
Female gender (& sexual intercourse)

Question 3

What are some organisms that commonly cause UTIs?

Answer 3

E coli

Proteus

Klebsiella

Enterococcus

Pseudomonas

Question 4

What are some signs / symptoms of UTIs in children?

Answer 4

Diarrhoea	
Excessive crying
Fever
Nausea and vomiting
Not eating

Question 5

What are some signs / symptoms of UTIs in adults?

Answer 5

Flank pain
Dysuria (severe pain)
Cloudy offensive urine
Urgency
Chills
Strangury (pain and desire to urinate)
Confusion (very old people)

Question 6

What are some clinical signs of acute pyelonephritis?

Answer 6

Kidney inflammation:

• Pyrexia
• Poor localization
• Loin tenderness
• Signs of dehydration
• Turbid (cloudy / opaque) urine

Question 7

What investigations are done for a UTI?

Answer 7

MSSU (mid-stream sample of urine), send to microbiology
>10^5 CFU/mL (CFU = colony-forming units)

• Urinalysis (blood / leucocytes / protein / nitrates)

Question 8

What are the focuses of treatment when it comes to UTIs?

Answer 8

1. Antibiotic the infecting ting

2. Treat underlying pathology (usually only necessary in men / children / complicated cases)

Question 9

Management of UTIs? (uncomplicated)

Answer 9

Fluids and antibiotics (IV antibs if severe infection)

• Amoxicillin (3-5 day course), cephalosporin, Trimethoprim

Question 10

What is vesicoureteral relfux? What can this cause in children with UTIs?

Answer 10

• Reflux of urine from bladder into ureters due to congenital abnormalities
• Can cause reflux nephropathy (kidney damage) if in association with UTIs

Question 11

How is chronic pyelonephritis diagnosed? What are some possible complications?

Answer 11

• Radiology: scarring and renal clubbing (of calyx)

- Hypertension and chronic renal failure