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Pathology
Bacterial or fungal infection of the urinary tract.
More common in women due to shorter urethra and proximity to anus
Aetiology
Common organisms: E. Coli, Proteus, Pseudomonas, Klebsiella and Enterococcus
Signs
Simple UTI: Supra-pubic tenderness
Pyelonephritis: Renal angle tenderness, fever
Symptoms
Simple UTI: Frequency, urgency dysuria, nocturia, haematuria
Pyelonephritis: Loin pain, fever, rigors, vomiting and frequency
Investigations
Bloods: FBC, CRP, U&E and blood cultures if systemically unwell
MSU: Urine dipstick and MC&S
Imaging: KUB X-ray to rule out stone disease
Treatment
Conservative Management: Increase fluid intake, encourage double voiding,
voiding after intercourse and hygiene advice
Antibiotics - If prescribing empirical antibiotics ensure sensitivities are checked
Trimethoprim, amoxicillin and nitrofurantoin commonly used.
If systemically unwell consider IV gentamicin
Prognosis
Normally a full and rapid recovery occurs.
Urosepsis, renal abscess, renal papillary necrosis
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