Risk factors of UTI
Secual intercourse
Urinary stasis
Catheters
What is cystitis?
Infection of the bladder
Clinical presentations of cystitis?
Dysuria
Urinary frequency
Suprapubic pain
Systemic signs usually absent
What are the laboratory findings in cystitis?
Urinalysis – cloudy urine with > 10 WBCs/high power field
Dipstick – Positive leukocyte esterase (due to pyuria)
Culture – greater than 100,000 colony forming units (gold standard)
What are the bacterial species that cause cystitis?
E coli (80%)
Staphylococcus saprophyticus
Klebsiella pneumoniae
Proteus mirabilis
Enterococcus faecalis
What is sterile pyuria and what condition is it sugesstive of?
Sterile pyuria is the presence of pyuria with a negative urine culture
Suggests urethritis due to Chlamydia trachomatis or Neisseria gonorrhoaea
What is pyelonephritis?
Infection of the kidney usually due to ascending infection
Clinical presentations of pyelonephritis
Fever
Flank pain
WBC casts
Leukocytosis
Most common pathogens of pyelonephritis
E coli
Klebsiella species
Enterococcus faecalis
What is chronic pyelonephritis?
Interstitial fibrosis and atrophy of tubules due to multiple bouts of acute pyelonephritis
due to vesicoureteal reflux (children) or obstruction
What damage to the kidneys result from chronic pyelonephritis?
Leads to cortical scarring with blunted calyces
Scarring at upper and lower poles is characteristic of vesicoureteral reflux
What kind of casts may be seen in chronic pyelonephritis?
Waxy casts
They result from atrophic tubules containing eosinophilic proteinacious material that resemble thyroid follicles
