UTI and pyelonephritis

Question 1

What are the the 2 types of UTI?

Answer 1

Lower - infection of the bladder usually caused by bacteria from the GI tract

Upper - infection of the ureters and kidneys

Question 2

What are the symptoms of a lower UTI?

Answer 2

Dysuria

Increased frequency

Increased urgency (i.e., when they need to go they need to go and can be incontinent)

Suprapubic tenderness

Nocturia

Malodorous urine

There could be haematuria

Fever

Cloudy urine

Question 3

Along with dysuria (which can present alone), name the other signs/symptoms that indicates a UTI in men aged 65 years or over

Answer 3

Temperature 1.5ºC above normal twice in 12 hours.

New frequency or urgency.

New incontinence.

New or worsening delirium/debility.

New suprapubic pain.

Visible haematuria.

Question 4

Sources

Answer 4

https://cks.nice.org.uk/topics/urinary-tract-infection-lower-men/diagnosis/suspecting-a-urinary-tract-infection/

https://cks.nice.org.uk/topics/urinary-tract-infection-lower-women/diagnosis/when-to-suspect-uti/

https://cks.nice.org.uk/topics/pyelonephritis-acute/diagnosis/signs-symptoms/

Question 5

What are the signs/symptoms of pyelonephritis?

Answer 5

Renal angle tenderness

Fever (raised temperature > 37.9°C or higher or below 36°C in people aged over 65 years) / Rigors

Flu-like symptoms

Myalgia

N+V

Typically sudden onset

Question 6

What are the DDx of a UTI in a male?

Answer 6

Acute prostatitis

Bladder/renal malignancy

LUTS

Epidydimo-orchitis

BPH

Urethritis

Pyelonephritis

STIs

Question 7

What are the DDx of a UTI in a female?

Answer 7

Pyelonephritis

Pregnancy (esp. ectopic)

Bladder/renal malignancy

Urethritis

Gynaecological malignancy e.g., ovarian cancer which may present with increased urinary frequency and urgency

PID / STIs