Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- 59 Urethritis and dysuria
- 60 Vaginitis and cervicitis
- 61 Epididymo-orchitis
- 62 Genital ulcer adenopathy syndrome
- 63 Prostatitis
- 64 Pelvic inflammatory disease
- 65 Urinary tract infection
- 66 Candiduria
- 67 Focal renal infections and papillary necrosis
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
65 - Urinary tract infection
from Part VIII - Clinical syndromes: genitourinary tract
Published online by Cambridge University Press: 05 April 2015
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- 59 Urethritis and dysuria
- 60 Vaginitis and cervicitis
- 61 Epididymo-orchitis
- 62 Genital ulcer adenopathy syndrome
- 63 Prostatitis
- 64 Pelvic inflammatory disease
- 65 Urinary tract infection
- 66 Candiduria
- 67 Focal renal infections and papillary necrosis
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
Summary
Urinary tract infections (UTIs) are the most common infections identified in both outpatient and inpatient settings. UTIs occur in patients of all ages, affecting females throughout life and males at each end of the age spectrum. They represent approximately 8.6 million visits in the ambulatory setting and are the most commonly diagnosed healthcare-associated infection. The term urinary tract infection encompasses a group of conditions that includes cystitis, pyelonephritis, and asymptomatic bacteriuria. Appropriate management of a patient with a UTI requires consideration of multiple factors, including age, sex, underlying comorbidities, pregnancy, history of prior UTIs, location of infection, and the pathogen involved.
Determination of the location of the infection as upper versus lower tract is essential to selection of optimal therapy. Lower urinary tract infection is infection involving the bladder, or cystitis, and is characterized by dysuria, pyuria, urinary frequency, or urinary urgency. Upper urinary tract infection, or pyelonephritis, is infection involving the bladder and kidney that classically presents with fever and flank pain, with or without the symptoms of lower tract infection.
Differentiating uncomplicated from complicated UTI is also critical to developing an appropriate treatment strategy. An uncomplicated UTI is an infection occurring in an otherwise healthy individual who has no functional or structural abnormalities of the kidneys, ureters, bladder, or urethra. Most adult women with cystitis fall into this category. Complicated UTIs are those infections occurring in the setting of functional or anatomic abnormalities of the upper or lower tract (such as urinary retention from anatomic obstruction or neurogenic bladder and nephrolithiasis), in the presence of an indwelling bladder catheter, or in patients with underlying conditions such as pregnancy, diabetes mellitus, or renal transplantation.
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- Clinical Infectious Disease , pp. 421 - 429Publisher: Cambridge University PressPrint publication year: 2015