Flashcards in 42. Urinary tract infection (acute bacterial cystitis) Deck (18):
urinary tract infenction (UTI) is
inflammation of urinary tract
urinary tract infenction presents as
1. suprapubic pain
3. urinary frequency
SYSTEMIC SYMPTOMS ARE USUALLY ABSENT
pain gull or difficult urination
UTI risk factors
1. femlae ( short urethra)
2. sexual intercourse ( honeymoon cystitis)
4. diabetes mellitus
5. impaired bladder emptying
UTI - bags
3. Klebsiella pneumoniae
4. Serratia marcescens
6. Proteus mirabilis
7. Pseudomonas aeruginosa
3 MCC of UTI ( in order
Serratia maarcescens - special features (2)
1. red pigmant ( some stains )
2. often nosocomial and drug resistance
UTI seen in sexually active women ( 2 bugs in order)
UTI diagnostic markers
1. leukocyte esterase ---> WBC activity
2. + Nitrate test ---> reduction of urinary nitrates by bacterial species ( indicates gram (-) organism , esp . E.coli)
3. +Urease test --> urease - producing bags ( eg Proteus Klebsiella0
Sterile pyuria and (-) urine cultures suggest
urethritis by Neisseria gonorrhoeae or CHlamydia trachomatis
• A sexually active teen has dysuria and urinary frequency. Pyuria is sterile and urine cultures negative. What organism(s) are responsible?
Neisseria gonorrhea and Chlamydia trachomatis (the patient has urethritis)
• As soon as a postoperative patient is able to ambulate with assistance, his indwelling Foley catheter is removed. Why?
To prevent the development of acute infectious cystitis (indwelling catheters are a significant risk factor)
• A patient's urinalysis is positive for nitrites and leukocyte esterase. What is the most likely culprit?
E. coli (the most common cause of acute infectious cystitis and associated with nitrites on urinalysis)
• An elderly woman has urinary urgency and dysuria. Her urine has an ammonia-like odor to it. Diagnosis?
She has acute infectious cystitis secondary to Proteus mirabilis
• Cystitis develops in a young woman. Urinalysis shows leukocyte esterase and no nitrites. Urine culture shows no E. coli. Diagnosis?
Staphylococcus saprophyticus cystitis (common in young sexually active women)
• A patient presents with suprapubic pain, dysuria, urinary frequency, and urgency. You check vital signs. Do you expect to see a fever?
No (acute infectious cystitis is not usually associated with systemic signs such as fevers and chills)
• List some risk factors for acute infectious cystitis.
Female sex (short urethra), sexual intercourse ("honeymoon cystitis"), indwelling catheters, diabetes mellitus, impaired bladder emptying