Urinary Tract Infections (UTI) are a very common bacterial infection primarily affect the lower urinary tract, involving the bladder and other structures. Most are caused by Escherichia coli and Klebsiella.
F>M; Varies from an asymptomatic bacteriuria to a symptomatic acute urethritis to a septicaemia.
Risk factors: diabetes mellitus; dehydration, pregnancy; genitourinary malformation; menopause, incomplete bladder emptying, poor hygiene, catheter use
Clinical features:
Usually abrupt onset of frequency of micturition and dysuria with pain during micturition. Maybe intense desire to pass more urine after emptying bladder due to spasm of inflamed bladder wall; incontinence; may have a fever.
Urines appears cloudy and may have a strong smell.
Back pain suggests that it may have spread to the kidney (usually get vomiting and nausea).
Diagnosis is usually based on symptoms and a urinalysis.
Management:
Many will resolve spontaneously.
Antibiotics; drink frequently; double voiding (go again after 5 mins);
Drinking cranberry juice may also be helpful.
Urinary alkalinizer’s (eg URAL) may be tried to neutralise the acidity of the urine to reduce the painful, burning symptoms.
Acute Pyelonephritis:
This is a bacterial infection that causes an inflammation of the kidneys that generally comes from an ascending urinary tract infection spreading from the bladder to the kidneys. Escherichia coli is the most common.
Clinical features:
Sudden onset of pain in loins that tends to radiate.
Usually have fever, rigours and nausea or vomiting
Differential: appendicitis, abscess, nephrolithiasis, cholecystitis, urinary tract obstruction, pancreatitis
Management:
Usually: antibiotics, analgesics and antipyretics.
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