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Urinary Tract Infection (U.T.I)

URINARY TRACT INFECTIONS:

File:Pyuria.JPG

A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract.The main causitive agent is:Escherichia coli. Although urine contains a variety of fluids, salts, and waste products, it usually does not have bacteria in it.[1] When bacteria get into the bladderor kidney and multiply in the urine, they cause a UTI. The most common type of UTI is a bladder infection which is also often called cystitis. Another kind of UTI is a kidney infection, known as pyelonephritis, and is much more serious. Although they cause discomfort, urinary tract infections can usually be quickly and easily treated with a short course of antibiotics.[2]

“Multiple white cells at urinary microscopy from a patient with urinary tract infection.”

Symptoms

For bladder infections

  • Frequent urination along with the feeling of having to urinate even though there may be very little urine to pass.
  • Nocturia: Need to urinate during the night.
  • Urethritis: Discomfort, irritation or pain at the urethral meatus or a burning sensation throughout the urethra with urination (dysuria).
  • Pain in the midline suprapubic region.
  • Pyuria: Pus in the urine or discharge from the urethra.
  • Hematuria: Blood in urine (not always seen to the naked eye, but often revealed during urine tests).
  • Pyrexia: Mild fever
  • Cloudy and foul-smelling urine
  • Increased confusion and associated falls are common presentations to Emergency Departments for elderly patients with UTI.
  • Some urinary tract infections are asymptomatic.

.

For kidney infection

  • All of the above symptoms.
  • Emesis: Vomiting is common.[3]
  • Back, side (flank) or groin pain.
  • Abdominal pain or pressure.
  • Shaking chills and high spiking fever.
  • Night sweats.
  • Extreme fatigue.
  • Excessive thirst.

.

File:Bacteriuria pyuria 4.jpg

Multiple bacilli (rod-shaped bacteria, here shown as black and bean-shaped) shown between white cells at urinary microscopy. This is called bacteriuria and pyuria, respectively. These changes are indicative of a urinary tract infection.

Diagnosis

A patient with dysuria (painful voiding) and urinary frequency generally has a spot mid-stream urine sample sent for urinalysis, specifically the presence ofnitritesleukocytes or leukocyte esterase. If there is a high bacterial load without the presence of leukocytes, it is most likely due to contamination. The diagnosis of UTI is confirmed by a urine culture.

If the urine culture is negative:

A negative urine test can also suggest the presence of unusual bacteria or viruses causing symptoms of UTI.

In severe infection, characterized by feverrigors or flank pain, urea and creatinine measurements may be performed to assess whether renal function has been affected.

Most cases of lower urinary tract infections in females are benign and do not need exhaustive laboratory work-ups. However, UTI in young infants must receive some imaging study, typically a retrograde urethrogram, to ascertain the presence/absence of congenital urinary tract anomalies. Males too must be investigated further. Specific methods of investigation include x-ray, Nuclear Medicine, MRI and CAT scan technology.

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See also

References

  1. ^ “Adult Health Advisor 2005.4: Bacteria in Urine, No Symptoms (Asymptomatic Bacteriuria)”. Retrieved 2007-08-25.
  2. ^ “Urinary Tract Infections”. Retrieved 2007-08-25.
  3. ^ askdrsears.com
  4. ^ Urethra length is approximately 25–50 mm / 1-2 inches long in females, versus about 20 cm / 8 inches in males.
  5. ^ “Fluroquinolone Drug Class Review”. Oregon State University College of Pharmacy. 2002. Retrieved 4 September 2009.
  6. a b http://findarticles.com/p/articles/mi_m0689/is_2_52/ai_97724151/
  7. ^ “BestBets: Cranberry Juice for the treatment of UTIs”.
  8. ^ Urinary Tract Infection – Alternative medicine. Accessed October 4, 2008.
  9. ^ Urinary Tract Infection – eMedicine Health. Accessed December 26, 2008.
  10. ^ Toxic Shock Syndrome: Bacterial Infections by Matthew E. Levison, MD(September 2008)Merck Manual Home Edition

January 27, 2010 - Posted by | Blood, Cells, Pancreas

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