19. UTI Flashcards
(27 cards)
Sx of cystitis
Urinary frequency, urgency, dysuria, suprapubic tenderness, gross haematuria sometimes
Sx of pyelonephritis
Cysitis + fevers, rigors, lethargy, loin pain/ paravertebral tenderness
Most common pathogens in cystitis
E coli, klep, proteus, staph saprophyticus in young women
Common uropathogens in pts with recent antimicrobials, hopsitalisation and cathether
pseudomonas, enterococcus, staphylococci
What does urinalysis show for UTI
Leukocyte, nitrites
Ix for UTI
MSU - only on Sx patients except pregnant women
>100000 = bacteriuria
Risk factors for cystitis
Sexual activity, recent UTI, DM, UT abnormalities, post-menopause
Ix of women <65 yo with cystitis
Treat emprically if 3 or more sx, urinalysis if 2 sx or less
MSU ONLY if risk of MDR or if pts do not respond to first line
Sx of prostatitis
Pelvic or perineal pain, dribbling and hesitancy
Tx of acute cystitis
3 day (F) 7day (M) Trim or nitro
Contra for nitro
Avoid if eGFR <45
Alternative for Nitro and Trim in pregnant women
Cefalexin
Mx of recurrent UTI
Check renal fx and UT USS
Trim post intercourse, standby abx or prophylactic abx
Non prescription recc for recurrent cystitis
Better byrdration and frequent urination, urge initiated voiding and post coital voiding.
What increases risk of pyelonephritis
Renal stones, immunocompromise, diabetes and pregnancy
What does discharge and irch suggest in UTI like sx
Pelvic inflammatory disease
Sx of prostatitis
Pelvic/perineal itch
Ix for acute pyelonephritis
Urine culture, urinalysis- absence of pyuria may indiciate alternative dx
What ix for pyelonephritis
Renal Tract USS or CT if pt is severely unwell, has persisting clinical sx or UT obstruction (urinary stones , urological surgery eg. stents) AKI or recurrent sx
How to mx pyelonephritis
Admit only if septic, high risk of complications, can’t take oral medication or possible UTO
Abx of pyelonephritis
IV amox and gent
Cotrim, co amoxiclav and cipro
Sx of UTI in catherised pts
New fever, rigors, delirium
Flank pain
Pelvic discomfort
Acute haematuria
In pts whom cathether had been removed - dysuria, urgency, suprapubic pain
To do dipstick on catheterised pts?
No
Must send urine for culture
Send bloods and blood cultures
Should asymptomatic bacteriuria be treated for cathetherise patients
NO
