What is infection of the epididymis/testis called?
What is the most common type of hospital acquired infection?
What are the general predisposing factors which make an individual more susceptible to UTI?
Female sex (short urethra)
Sexual intercourse and poor voiding habits
Congenital abnormalities e.g. duplex kidney
Stasis of urine e.g. due to poor bladder emptying
Foreign bodies eg catheters, stones
Oestrogen deficiency in postmenopausal women
Fistula between bladder & bowel
Name three organisms capable of causing a UTI
What is the possible consequence of ascension of UTI?
Pyelonephritis and acute kidney injury
What are the clinical features of UTI in children?
–Nausea and vomiting
What are the clinical features of UTI in adults?
–Dysuria (“like passing broken glass”)
–Cloudy offensive urine
–Strangury - feeling if having not voided even though they have
–Confusion (very old people)
What are the clinical features of acute pyelonephritis?
•Loin tenderness (renal angle)
•Signs of dehydration
What are the investigations for UTI?
•Urinalysis In ward
•Microbiology In laboratory
–Microscopy and Gram staining
–Bacteruria >105 CFU /ml
Culture and sensitivity
What are the relevant investigations for children, men or when UTIs are frequent?
–Ultrasound or IVU may be helpful
–Isotope studies to rule our reflux and scarring
What are the principles of management of UTI?
1 Identify the infecting organism & institute appropriate treatment
2 Identify predisposing factors and treat if possible
What is the treatment of UTI?
Amoxicillin (3-5 day course or 3g x 2), cephalosporin
When is renal impairment likely to occur after a urinary tract infection?
If the urinary tract is functionally normal (on imaging) - repeated / persistent UTI's seldom result in renal damage
If there is anotomical / neurological abnormalities / stones / diabetes - may cause infections and sometimes lead to renal impairment
What is a congenital cause of UTI's in children?
Reflux and infection
What is the relevant investigation for reflux nephropathy?
Micturating cystogram (radionuclide 99 Tc techniques)
Assessment of pregression by ultrasound scan and biochemistry
What is the treatment for reflux nephropathy?
What are the recommended drinking habits and voiding habits for recurrent infections?
•Fluid intake 2l / day
•Void every 2-3 hours by day
•Void before bedtime & before and after intercourse
What are the radiological findings of chronic pyelonephritis?
Scarring and clubbing