Urinary Tract Infections Flashcards
Acute Cystitis
Bladder infection, UTI
Acute Cystitis Etiology
Due to coliform bacteria (E coli) or G+ bacteria (enterococci)
- Infection ascends from urethra to bladder
- Rare in men and implies a pathologic process that requires further investigation
Acute Cystitis S/S
Dysuria, urinary frequency, urgency, usually afebrile
- Gross hematuria
- Suprapubic tenderness
Acute Cystitis Lab
UA: pyuria, hematuria, bacteriuria -leukocyte esterase and nitrites -WBCs and RBCs under scope Urine culture: pos Urine culture and sensitivity if empiric tx fails or an early relapse (less than 2 wks)
Acute Cystitis Management
Tx: Trimethroprim/ Sulfamethoxazole x 3 days
or Nitrofurantoin x 5 days
-Fluoroquinolone in pts with allergy but areas have high rates of resistance
Symptomatic relief: hot sitz baths or urinary analgesics
Acute Cystitis Prevention
-Complicated cases should be further investigated to determine the underlying cause
-Don’t use spermicide or diaphragm as birth control (for a variety of reasons…)
Women w/ 3+/year should get prophylactic abx therapy (single dose at bedtime or at time of intercourse)
Recurrent Cystitis Etiology
- Occurs after a documented infection has resolved
- due to: genetic predisposition, altered vaginal flora, post coital infection
Recurrent Cystitis S/S
Same as acute but quick relapse
Recurrent Cystitis Lab
Urine culture and sensitivity
-consider urologic work up to evaluate anatomical abnormalities
Recurrent Cystitis Management
Tx for 7-14 days
Asymptomatic bacteriuria Etiology
More common with older age, spinal cord injuries, hemodialysis pts
Asymptomatic bacteriuria S/S
No local or systemic symptoms can be present!!
-Usually discovered when undergoing unrelated urine culture screening
Asymptomatic bacteriuria Lab
Urine culture pos without symptoms
Asymptomatic bacteriuria Management
Do not treat!! Unless pregnant, before urologic intervention, prior to hip replacement, if they become symptomatic
Pyelonephritis
Infectious inflammatory disease involving the kidney parenchyma and renal pelvis