Thursday, March 10, 2011

Urinary tract infection

Urinary tract infection is the most common bacterial infection managed in general medical practice and accounts for 1-3% of consultations. Up to 50% women have a UTI at some time. In male UTI is uncommon. Most common presentation of UTI is acute urethritis and cystitis.

Spectrum of presentation:

1) Asymptomatic bacteriuria
2) Acute pyelonephritis
3) Symptomatic acute urethritis & cystitis
4) Acute prostatitis
5) Septicaemia

Common causes:

1) E. coli
2) Klebsiella
3) Proteus
4) Pseudomonus
5) Streptococci
6) Staphylococci epidermidis
7) In Hospitals- E. coli , Klebsiella and streptococci

Risk factors:

1) incomplete bladder emptying :

a) bladder outflow obstruction
b) neurological problems-
multiple sclerosis
diabetic neuropathy
c) gynaecological abnormalities-
uterine prolapse
d) vesico ureteric reflux

2) foreign body-

a) urethral catheter
b) ureteric stent

3)loss of host defence-

a) diabetes mellitus
b) atrophic urethritis and vaganitis in post menopausal women

Differential diagnosis:

1) urethritis
2) vaginitis

Clinical feature :

1) abrupt onset of frequency of micturation and urgency
2) dysuria
3) supra pubic pain during and after voiding
4) stranguary
5) urine may appear cloudy and have an unpleasant odur
6) microscopic or visible heamaturia
7) fever, rigor, vomitting

Investigations :

1) Dipstick examination - nitrite, leucocyte esterase and glucose
2) urine R/E - for pus cell and epithelial cell ( > 5-6)
3) urine culture (midstream urine)
4) CBC
5) Blood culture
6) USG
7) Serum urea ,electrolytes, creatinine
8) Cystoscopy

Management:

1) fluid intake at least 2 litre per day
2) regular complete emptying of bladder
3) good personal hygiene
4) emptying of bladder before and after sexual intercourse
5) if vesico ureteric reflux is present practice double micturation
6) antibiotics according to the report of urine culture
  • ciprofloxacin - 500mg 12 hourly for 3 days
  • trimethoprim - 200 mg 12 hourly for 3 days
  • nitrofurontion - 50 mg 6 hourly for 3 days
  • coamoxiclav - 500/ 125mg 8 hourly for 3 days
Seriously ill patient I/V cefuroxime -750 mg 8 hourly for 3-14 days
In pregnancy - penicillin and cephalosporins

Edited by ImAn NoOr




29 comments:

  1. Appreciate this post. Will try it out.
    Have a look at my homepage ... xxxvideofix.com

    ReplyDelete
  2. I usually do not leave a response, but I looked at a great
    deal of responses on "Urinary tract infection".
    I do have a couple of questions for you if it's okay. Could it be just me or do a few of these comments look as if they are written by brain dead individuals? :-P And, if you are posting at additional online social sites, I'd
    like to keep up with everything fresh you have to post.

    Would you post a list of all of all your public
    pages like your Facebook page, twitter feed, or linkedin profile?
    Also visit my webpage ... Videos

    ReplyDelete
  3. Excellent site you have here but I was curious
    about if you knew of any message boards that cover the same topics talked about here?
    I'd really love to be a part of community where I can get feedback from other knowledgeable individuals that share the same interest. If you have any suggestions, please let me know. Thank you!
    Have a look at my blog :: teen porn

    ReplyDelete
  4. Way cool! Some very valid points! I appreciate you
    writing this article plus the rest of the website is extremely good.
    Take a look at my web site ... teen porn

    ReplyDelete
  5. I love what you guys tend to be up too. This kind of
    clever work and exposure! Keep up the terrific works
    guys I've added you guys to our blogroll.
    Also see my page :: www.daily-wet-tshirt.com

    ReplyDelete
  6. If you are going for most excellent contents like me, simply pay a quick
    visit this web site daily as it offers feature contents, thanks
    Also visit my homepage nude teens

    ReplyDelete
  7. Ηello Theгe. I found your blοg usіng msn.

    Τhis is a rеаlly well ωritten article.
    I will be sure to bookmark it and come bаck
    to read more of your useful informаtion.
    Тhanks for the post. I will certaіnly return.
    Also visit my web-site ... http://www.onlinepaydayloansking.co.uk

    ReplyDelete
  8. But the advent оf unemployed spеedy ρеrsonal loans has chаnged thiѕ misсοnception You'll find the top lender with all the best charge deal Once the lease is over, you might have two options left: to help re-qualify to continue a lease as well as to purchase
    My web page : www.onlinepaydayloansking.co.uk

    ReplyDelete
  9. Howdy. I was thinking about adding a backlink back to your blog since both of our websites are
    based around the same subject. Would you prefer I link to you using your website address: http://www.
    blogger.com/comment.g?blogID=9085261781850668853&postID=5465814714843326233 or
    blog title: Blogger: Medical World. Please let me know
    at your earliest convenience. Thanks!

    Stop by my webpage :: folija

    ReplyDelete
  10. oZzy moved away ever before, I miss his cock,
    and i am always hungry for sexual intercourse.

    FUCK MY PUSSY!

    my web-site - hcg injections

    ReplyDelete
  11. Pretty nісe post. ӏ just ѕtumbleԁ upon your blog аnԁ wished to say thаt I haѵe rеаlly enjoyeԁ surfing аround your weblog pоsts.
    After аll I wіll bе subscrіbіng for youг rss
    feеd anԁ I'm hoping you write again very soon!

    My blog post - house for rent highland park

    ReplyDelete
  12. My family always say that I am wasting my time here
    at web, but I know I am getting familiarity everyday by reading such
    fastidious posts.

    Take a look at my site :: Abercrombie & Fitch

    ReplyDelete
  13. Pretty! This was an extremely wonderful article. Thanks for providing
    this information.

    Here is my web-site ... Air Max

    ReplyDelete
  14. I was suggested this website by my cousin. I am no longer certain whether this put up is written by him as no one else understand such certain approximately my problem.
    You are wonderful! Thank you!

    My webpage :: Cheap Louis Vuitton Bags

    ReplyDelete
  15. This is for the reason that no matter this many amazing tools that can exist done with it,
    they may lead to matters. Professionalism is the most important thing to
    get the best advantages in any community especially
    SEO.

    Feel free to surf to my web blog best affordable seo services

    ReplyDelete
  16. Ӏf you wish fοr to increase youг know-how juѕt keeρ visiting thіs web site and bе uρdated wіth the newest
    gossip posted here.

    Fееl free to vіsit my blοg ρost;
    hcg diet drops

    ReplyDelete
  17. Hi, the whole thing is going nicely here and ofcourse every one is sharing information,
    that's truly good, keep up writing.

    my site :: Louis Vuitton Outlet1

    ReplyDelete
  18. Pretty section of content. I just stumbled upon your web site and
    in accession capital to assert that I acquire in
    fact loved account your blog posts. Anyway I will be subscribing to your augment or even I
    success you get admission to persistently fast.

    My blog post Louis Vuitton Pas Cher

    ReplyDelete
  19. Wonderful blog you have here but I was wondering if you knew of any forums that cover the
    same topics talked about here? I'd really like to be a part of online community where I can get comments from other experienced individuals that share the same interest. If you have any suggestions, please let me know. Thank you!

    Here is my web blog Michael Kors Outlet

    ReplyDelete
  20. Hello I am so excited I found your site, I really found you by error, while I was
    searching on Google for something else, Anyways I am
    here now and would just like to say thank you for a marvelous post and a all round
    interesting blog (I also love the theme/design), I don’t have time to go through it all at the
    moment but I have bookmarked it and also added in your RSS feeds, so when
    I have time I will be back to read a great deal more, Please do keep
    up the fantastic b.

    Feel free to visit my page - resources

    ReplyDelete
  21. Things i have seen in terms of computer memory is the fact there are technical specs such as SDRAM, DDR and many others, that must match the features of the motherboard. If the personal computer’s motherboard is fairly current while there are no operating-system issues, changing the memory literally takes under sixty minutes. It’s one of several easiest personal computer upgrade techniques one can picture. Thanks for giving your ideas. softmedia

    ReplyDelete
  22. Some genuinely prize articles on this web site , saved to bookmarks . I found this similiar one here

    ReplyDelete