Urinary tract infection

From Citizendium, the Citizens' Compendium

In medicine, urinary tract infections are "inflammatory responses of the epithelium of the urinary tract to microbial invasions. They are often bacterial infections with associated bacteriuria and pyuria."^[1]

Contents 1 Classification 2 Cause 2.1 Males 3 Diagnosis 4 References

Classification

More common types of urinary tract infections in include:

• Pyelonephritis
• Cystitis
• Urethritis

Cause

Males

In males, urinary tract infections are usually secondary to an underlying cause such as benign prostatic hyperplasia or genitourinary instrumentation.^[2] However, a single episode is unlikely to be due to a serious underlying cause.^[3]

Diagnosis

The best symptoms and physical examination findings for diagnosis have been identified in a systematic review by the Rational Clinical Examination in 2002.^[4]

Regarding symptoms, a subsequent study and clinical prediction rule found the best findings are urine cloudiness, offensive smell, moderately severe dysuria, moderately severe nocturia.^[5]

A subsequent study and clinical prediction rule showed the best predictors were urinary nitrite, leucocyte esterase and blood.^[5]

Urinary tract infections may be overdiagnosed in geriatric patients.^[6]

References

1. ↑ Anonymous, (2009) Urinary tract infection (English). Medical Subject Headings. U.S. National Library of Medicine.
2. ↑ Lipsky BA (January 1989). "Urinary tract infections in men. Epidemiology, pathophysiology, diagnosis, and treatment". Ann. Intern. Med. 110 (2): 138–50. PMID 2462391.
3. ↑ Abarbanel J, Engelstein D, Lask D, Livne PM (July 2003). Urinary tract infection in men younger than 45 years of age: is there a need for urologic investigation?. Urology 62 (1): 27–9. PMID 12837416.
4. ↑ Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S (2002). Does this woman have an acute uncomplicated urinary tract infection?. JAMA 287 (20): 2701–10. PMID 12020306.
5. ↑ ^5.0 5.1 Little P, Turner S, Rumsby K, Warner G, Moore M, Lowes JA et al. (2009). Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study.. Health Technol Assess 13 (19): iii-iv, ix-xi, 1-73. DOI:10.3310/hta13190. PMID 19364448. Review in: Evid Based Med. 2009 Oct;14(5):155
6. ↑ Woodford HJ, George J (November 2008). Diagnosis and Management of Urinary Tract Infection in Hospitalized Older People. J Am Geriatr Soc. DOI:10.1111/j.1532-5415.2008.02073.x. PMID 19054190.