Renal

Urinary Tract Infection

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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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