SlideShare a Scribd company logo
Urinary Tract Infections
Mohammad Yahya Tailakh
5th year medical student
University of Jordan
What is UTI?
 Inflammation of the urothelium due to microorganism invasion.
 Urinary tract infection is a term that is applied to a variety of clinical conditions ranging
from the asymptomatic presence of bacteria in the urine to severe infection of the
kidney with resultant sepsis.
 Clinical presentation:
 The most frequent chief complaint related to urinary tract infection (UTI) is dysuria.
 urinary frequency, and urgency are approximately 75% predictive for UTI.
 acute onset of hesitancy, urinary dribbling, and slow stream are only approximately 33%
predictive for it.
anatomy
Epidemiology
 The incidence of true urinary tract infection (UTI) in adult males younger
than 50 years is low (approximately 5-8 per year per 10,000), with adult
women being 30 times more likely than men to develop a UTI. The incidence
of UTI in men approaches that of women only in men older than 60 years.
 in infants age group bacteriuria is more common in males while from 1-5
years its more common in females .
 The causes of UTI in peds is commonly caused by congenital anomalies
[reflux, obstruction]
General Definitions
 Recurrent UTI : more than 2 infections in 6 months or 3 infections in 1 year
 Isolated UTI : more than 6 months between one infection and another.
 Uncomplicated UTI : UTI in structurally and functionally (both) normal urinary
tract with normal immunity and low risk of bacterial virulence ,majority are
females
 Complicated UTI : one of these or more present; male, pt with structurally or
functionally abnormal kidney , immunocompromised , chance of increased
bacterial resistant (hx of ABx use or hospitalization) , majority are males i.e if
UTI occurred in a male its most likely to be complicated
 Bacteriuria : significant amount of bacteria in urine >10^5ml. sym or asym
[asym should be treated in :1-children 2- pregnancy 3- immunocompromised
 Pyuria : presence of WBC in urine more than 5 HPF. /sterile!
Without presence of bacteria.
Pyelonephritis
 • It means infection of the renal parenchyma and renal pelvis.
 Risk factors : VUR, DM, pregnancy, congenital malformation , indwelling
catheter, obstruction.
Types :
-Acute pyelonephritis
-Chronic pyelonephritis
-Emphysematous pyelonephritis
-Xanthogranulomatous pyelonephritis
Acute pyelonephritis
 Presentation ranges from mild illness to sepsis, pt may be well or ill.
 Signs and symptoms : loin pain, nausea, vomiting, fever, chills, rigor , may be
associated with lower UTI symptoms, tachycardia , costovertebral angle
tenderness
 Histology : neutrophils infiltrates
 M.c.c : ascending infection ; E.coli .
 Can be also Hematogenous ,lymphatics spread.
Investigation and treatment
 Investigations: UA ,culture,CBC [leukocytosis ], KFT[creatinine].
 Blood culture is preserved for immunocompromised patients
 TREATMENT :
 Out pt :oral flouroquinilone ,broad spectrum ABX .
 In pt : IV flouroquinolone s &aminoglycosides
 Urine culture should be repeated 1-2 wks after ABX.
Criteria for
admission to
hospital:
1- extremes of age
2- complicated
3- persistent vomiting
4- failure out pt
Clinical case
 65 year old male, diabetic, with IHD came to the ER with bilateral flank pain ,fever,
lower UTI symptoms , +ve renal angle and suprapubic tenderness,what to do ?
 it's a complicated UTI until proven otherwise
 Do CT scan without contrast
 If stone is found then its an obstructive pyelonephritis which is a life threatening
condition where pt may became shocked at anytime so Management will be with IV
fluids , IV antibiotics send blood culture don't remove the stone at this time but it’s
a must to relieve the obstruction by putting a uretric (double j) stent pr a
nephrostomy tube , after pt stabilization manage to remove the stone
Chronic pyelonephritis :
 Recurrent pyelonephritis .
 Causes : VUR ,chronic obstruction .
 Histology : fibrosis
 Signs and SX : asym to renal failure >. Fever, weight loss, nausea, vomiting,
flank pain
Emphysematous pyelonephritis :
 DM
 High mortality rate
 Gas forming bacteria m.c.c : E.coli ,klabsella , proteus.
Xanthogranulomatus pyelonephritis :
 rare, serious, chronic inflammatory disorder of the kidney characterized by a
destructive mass that invades the renal parenchyma.
 XGP is most commonly associated with Proteus or Escherichia coli infection
or Pseudomonas species.
 XGP is characterized by lipid-laden foamy macrophages.
 XGP shares many characteristics with true renal neoplasms in terms of its
radiographic appearance and its ability to involve adjacent structures or
organs
 Risk factors : urinary tract obstruction, infection, nephrolithiasis, diabetes,
and/or immunocompromise
 The overall prognosis for XGP is good
 CT scan shows renal calcification difficult to differentiate from CA
 Treatment :is a surgically managed disease that is treated with either
nephrectomy or, in rare circumstances, partial nephrectomy. Antibiotics are
used in all cases, but medical care rarely suffices for treatment.
Cystitis
 Inflammation of the urinary bladder .
 Most common organism : E.coli others : staph.saprophytics klebsiella,
 honeymoon cystitis .
 Types:
 -acute infectious
 -cystitis cystica and glandular cystitis
Brunn’s nests that grow into lamina propria and are transformed into urothelium lining slitlike or cystic spaces with pink fluid
 -follicular cystitis
 - hemorrhagic
 -interstitial
 Signs and SX: suprapubic pain ,dysuria ,frequency ,urgency , offensive smelled
urine, hematuria ,fever .
 invX : UA,culture
 TX : sulfamethoxazole
Urethritis
 Most common causative organism is neisseria gonorrhoea ,chlamydia .
 Signs and SX : dysuria ,discharge , meatal and penile shaft pain
 How ever ,no frequency or urgency .
 => if Dysuria without frequency then its urethritis
 gonococcal : present with sudden onset of large amount of yellow discharge
and mild dysuria
 non gonococcal : caused by clamydia trachomatis , present with gradual onset
of clear discharge
 Dx : urethral swab +culture .
 TX : sefoloxime ,azithromycin
Prostatitis
 is swelling and inflammation of the prostate gland, Due to reflux of infected
urine into prostatic duct.
 5% prevalence
 Risk factors : UTI, urethral catheter
 M.c organism : Ecoli, proteus, klebsiella
Classification
:
Acute bacterial prostatitis
Chronic bacterial
Chronic pelvic pain syndrome
Asymptomatic inflammatory
prostatitis (histologic)
Acute prostatitis :
 presentation is with lower urinary tract symptoms in the absence of loin pain
and presence of fever (most imp distinguishing factor),
 ttt is with broad spectrum ABx, it requires hospitalization, avoidance of
urethral catheter, if needed use suprapubic catheter
o Chronic prostatitis
 Causes :Recurrent infection , trauma .
 Sx : Painful bowel movement ,hematuria, painful voiding ,painful ejaculation
 treatment is with NSAID, steroids, alpha blockers, alpha reductase inhibitors,
if refractory to medical ttt microwave heat therapy
chronic pelvic pain syndrome
 is a pelvic pain condition in men, and should be distinguished from other
forms of prostatitis ,also known as Chronic nonbacterial prostatitis
 Signs and symptoms
 lasting longer than 3 months. Symptoms may wax and wane. Pain can range
from mild to debilitating. Pain may radiate to the back and rectum, making
sitting uncomfortable. Pain can be present in the perineum, testicles, tip of
penis, pubic or bladder area.[5] Dysuria, arthralgia, myalgia,
unexplained fatigue, abdominal pain, constant burning pain in the penis, and
frequency may all be present. Post-ejaculatory pain, mediated by nerves and
muscles, is a hallmark of the condition.
Causes
 Nerves, stress and hormones
 Food allergies
 Climate
Urinary tract infections

More Related Content

What's hot

Urinary tract infections
Urinary tract infectionsUrinary tract infections
Urinary tract infections
Asmatullah Sapand
 
UTI 02
UTI 02UTI 02
Urinary tract infection
Urinary tract infectionUrinary tract infection
Urinary tract infection
ajayyadav753
 
Urinary Tract Infection (UTI)
Urinary Tract Infection (UTI)Urinary Tract Infection (UTI)
Urinary Tract Infection (UTI)
SwethaPrasad12
 
Urinary disorders
Urinary disordersUrinary disorders
Urinary disorders
Blessy Susan
 
Urinary Tract Infections
Urinary Tract InfectionsUrinary Tract Infections
Urinary Tract Infections
yuyuricci
 
Uti
UtiUti
Pyelonephritis.pptx
Pyelonephritis.pptxPyelonephritis.pptx
Pyelonephritis.pptx
Pradeep Pande
 
UTI
UTIUTI
Urinary Tract Infection
Urinary Tract Infection Urinary Tract Infection
Urinary Tract Infection
Imran Ahammad Chowdhury
 
Urinary tract infection- a detailed medical study
Urinary tract infection- a detailed medical study Urinary tract infection- a detailed medical study
Urinary tract infection- a detailed medical study
martinshaji
 
Urinary tract infections (UTI) & Renal vascular diseases
Urinary tract infections (UTI) & Renal vascular diseasesUrinary tract infections (UTI) & Renal vascular diseases
Urinary tract infections (UTI) & Renal vascular diseases
yuyuricci
 
urinary tract infection
urinary tract infectionurinary tract infection
urinary tract infection
DJ CrissCross
 
urinary tract infection
urinary tract infectionurinary tract infection
urinary tract infection
Engidaw Ambelu
 
S ameer 2015 dysuria
S ameer 2015    dysuriaS ameer 2015    dysuria
S ameer 2015 dysuria
mt53y8
 
Uti
UtiUti
Urinary Tract Infections
Urinary Tract InfectionsUrinary Tract Infections
Urinary Tract Infections
Arwa M. Amin
 
Kidney infection or pyelonephritis
Kidney infection or pyelonephritis Kidney infection or pyelonephritis
Kidney infection or pyelonephritis
faculty of nursing Tanta University
 
Urinary Tract Infection
Urinary Tract InfectionUrinary Tract Infection
Urinary Tract Infection
Deep Deep
 
Acute and chronic glomerulonephritis
Acute and chronic glomerulonephritisAcute and chronic glomerulonephritis
Acute and chronic glomerulonephritis
jyoti dwivedi
 

What's hot (20)

Urinary tract infections
Urinary tract infectionsUrinary tract infections
Urinary tract infections
 
UTI 02
UTI 02UTI 02
UTI 02
 
Urinary tract infection
Urinary tract infectionUrinary tract infection
Urinary tract infection
 
Urinary Tract Infection (UTI)
Urinary Tract Infection (UTI)Urinary Tract Infection (UTI)
Urinary Tract Infection (UTI)
 
Urinary disorders
Urinary disordersUrinary disorders
Urinary disorders
 
Urinary Tract Infections
Urinary Tract InfectionsUrinary Tract Infections
Urinary Tract Infections
 
Uti
UtiUti
Uti
 
Pyelonephritis.pptx
Pyelonephritis.pptxPyelonephritis.pptx
Pyelonephritis.pptx
 
UTI
UTIUTI
UTI
 
Urinary Tract Infection
Urinary Tract Infection Urinary Tract Infection
Urinary Tract Infection
 
Urinary tract infection- a detailed medical study
Urinary tract infection- a detailed medical study Urinary tract infection- a detailed medical study
Urinary tract infection- a detailed medical study
 
Urinary tract infections (UTI) & Renal vascular diseases
Urinary tract infections (UTI) & Renal vascular diseasesUrinary tract infections (UTI) & Renal vascular diseases
Urinary tract infections (UTI) & Renal vascular diseases
 
urinary tract infection
urinary tract infectionurinary tract infection
urinary tract infection
 
urinary tract infection
urinary tract infectionurinary tract infection
urinary tract infection
 
S ameer 2015 dysuria
S ameer 2015    dysuriaS ameer 2015    dysuria
S ameer 2015 dysuria
 
Uti
UtiUti
Uti
 
Urinary Tract Infections
Urinary Tract InfectionsUrinary Tract Infections
Urinary Tract Infections
 
Kidney infection or pyelonephritis
Kidney infection or pyelonephritis Kidney infection or pyelonephritis
Kidney infection or pyelonephritis
 
Urinary Tract Infection
Urinary Tract InfectionUrinary Tract Infection
Urinary Tract Infection
 
Acute and chronic glomerulonephritis
Acute and chronic glomerulonephritisAcute and chronic glomerulonephritis
Acute and chronic glomerulonephritis
 

Similar to Urinary tract infections

Seminar on renal tuberculosis
Seminar on renal tuberculosisSeminar on renal tuberculosis
Seminar on renal tuberculosis
Vishal Golay
 
ПИЕЛОНЕФРИТ ПРЕЗЕНТАЦИЯ.pptx
ПИЕЛОНЕФРИТ ПРЕЗЕНТАЦИЯ.pptxПИЕЛОНЕФРИТ ПРЕЗЕНТАЦИЯ.pptx
ПИЕЛОНЕФРИТ ПРЕЗЕНТАЦИЯ.pptx
VishalBiswas20
 
Isk dwi lestari [compatibility mode]
Isk  dwi lestari [compatibility mode]Isk  dwi lestari [compatibility mode]
Isk dwi lestari [compatibility mode]
Joceline Theda
 
Urinary tract infection
Urinary tract infectionUrinary tract infection
Urinary tract infection
Navin Adhikari
 
L3. UTI@Nov2023.pptx
L3. UTI@Nov2023.pptxL3. UTI@Nov2023.pptx
L3. UTI@Nov2023.pptx
danielmwandu
 
Non tubercular infections of GUT- Dr Niranjan Patil.pptx
Non tubercular infections of GUT- Dr Niranjan Patil.pptxNon tubercular infections of GUT- Dr Niranjan Patil.pptx
Non tubercular infections of GUT- Dr Niranjan Patil.pptx
dypradio
 
Urinary tract disorder medical surgical nursing.ppt
Urinary tract disorder  medical surgical nursing.pptUrinary tract disorder  medical surgical nursing.ppt
Urinary tract disorder medical surgical nursing.ppt
ssuser47b89a
 
Uti
UtiUti
Pediatric Renal Disorders
Pediatric Renal DisordersPediatric Renal Disorders
Pediatric Renal Disorders
Dang Thanh Tuan
 
GU Infections
GU InfectionsGU Infections
GU Infections
Patrick Carter
 
Disorders of micturation
Disorders of micturationDisorders of micturation
Disorders of micturation
Natangwe Tangi
 
Urinary Tract Disorders
Urinary Tract DisordersUrinary Tract Disorders
Urinary Tract Disorders
ed falcon
 
Uti
Uti Uti
Urinary tract infection
Urinary tract infectionUrinary tract infection
Urinary tract infection
bausher willayat
 
Infections of the urinary tract final
Infections of the urinary tract finalInfections of the urinary tract final
Infections of the urinary tract final
Bimel Kottarathil
 
Urinary tract infections in obs & gynae
Urinary tract infections in obs & gynaeUrinary tract infections in obs & gynae
Urinary tract infections in obs & gynae
drmcbansal
 
medicine.Kidney3.(dr.alaa)
medicine.Kidney3.(dr.alaa)medicine.Kidney3.(dr.alaa)
medicine.Kidney3.(dr.alaa)
student
 
ABC of Uncomplicated Lower Urinary Tract Infection in women (PART -1 ) Dr Sha...
ABC of Uncomplicated Lower Urinary Tract Infection in women (PART -1 ) Dr Sha...ABC of Uncomplicated Lower Urinary Tract Infection in women (PART -1 ) Dr Sha...
ABC of Uncomplicated Lower Urinary Tract Infection in women (PART -1 ) Dr Sha...
Lifecare Centre
 
Urinary Tract Infections
Urinary Tract InfectionsUrinary Tract Infections
Urinary Tract Infections
FreeMedicine
 
Urinary tract infections
Urinary tract infections Urinary tract infections
Urinary tract infections
Chau Nguyen
 

Similar to Urinary tract infections (20)

Seminar on renal tuberculosis
Seminar on renal tuberculosisSeminar on renal tuberculosis
Seminar on renal tuberculosis
 
ПИЕЛОНЕФРИТ ПРЕЗЕНТАЦИЯ.pptx
ПИЕЛОНЕФРИТ ПРЕЗЕНТАЦИЯ.pptxПИЕЛОНЕФРИТ ПРЕЗЕНТАЦИЯ.pptx
ПИЕЛОНЕФРИТ ПРЕЗЕНТАЦИЯ.pptx
 
Isk dwi lestari [compatibility mode]
Isk  dwi lestari [compatibility mode]Isk  dwi lestari [compatibility mode]
Isk dwi lestari [compatibility mode]
 
Urinary tract infection
Urinary tract infectionUrinary tract infection
Urinary tract infection
 
L3. UTI@Nov2023.pptx
L3. UTI@Nov2023.pptxL3. UTI@Nov2023.pptx
L3. UTI@Nov2023.pptx
 
Non tubercular infections of GUT- Dr Niranjan Patil.pptx
Non tubercular infections of GUT- Dr Niranjan Patil.pptxNon tubercular infections of GUT- Dr Niranjan Patil.pptx
Non tubercular infections of GUT- Dr Niranjan Patil.pptx
 
Urinary tract disorder medical surgical nursing.ppt
Urinary tract disorder  medical surgical nursing.pptUrinary tract disorder  medical surgical nursing.ppt
Urinary tract disorder medical surgical nursing.ppt
 
Uti
UtiUti
Uti
 
Pediatric Renal Disorders
Pediatric Renal DisordersPediatric Renal Disorders
Pediatric Renal Disorders
 
GU Infections
GU InfectionsGU Infections
GU Infections
 
Disorders of micturation
Disorders of micturationDisorders of micturation
Disorders of micturation
 
Urinary Tract Disorders
Urinary Tract DisordersUrinary Tract Disorders
Urinary Tract Disorders
 
Uti
Uti Uti
Uti
 
Urinary tract infection
Urinary tract infectionUrinary tract infection
Urinary tract infection
 
Infections of the urinary tract final
Infections of the urinary tract finalInfections of the urinary tract final
Infections of the urinary tract final
 
Urinary tract infections in obs & gynae
Urinary tract infections in obs & gynaeUrinary tract infections in obs & gynae
Urinary tract infections in obs & gynae
 
medicine.Kidney3.(dr.alaa)
medicine.Kidney3.(dr.alaa)medicine.Kidney3.(dr.alaa)
medicine.Kidney3.(dr.alaa)
 
ABC of Uncomplicated Lower Urinary Tract Infection in women (PART -1 ) Dr Sha...
ABC of Uncomplicated Lower Urinary Tract Infection in women (PART -1 ) Dr Sha...ABC of Uncomplicated Lower Urinary Tract Infection in women (PART -1 ) Dr Sha...
ABC of Uncomplicated Lower Urinary Tract Infection in women (PART -1 ) Dr Sha...
 
Urinary Tract Infections
Urinary Tract InfectionsUrinary Tract Infections
Urinary Tract Infections
 
Urinary tract infections
Urinary tract infections Urinary tract infections
Urinary tract infections
 

More from mohammad tailakh

Fetal head diameters
Fetal head diametersFetal head diameters
Fetal head diameters
mohammad tailakh
 
Burns and sudden death
Burns and sudden deathBurns and sudden death
Burns and sudden death
mohammad tailakh
 
Empyema presentation
Empyema presentationEmpyema presentation
Empyema presentation
mohammad tailakh
 
Calcium channel blockers
Calcium channel blockersCalcium channel blockers
Calcium channel blockers
mohammad tailakh
 
Geriatrics health assessment
Geriatrics health assessmentGeriatrics health assessment
Geriatrics health assessment
mohammad tailakh
 
Knee disorders
Knee disordersKnee disorders
Knee disorders
mohammad tailakh
 
Ectopic pregnancy
Ectopic pregnancyEctopic pregnancy
Ectopic pregnancy
mohammad tailakh
 
Lens and cataract
Lens and cataractLens and cataract
Lens and cataract
mohammad tailakh
 

More from mohammad tailakh (8)

Fetal head diameters
Fetal head diametersFetal head diameters
Fetal head diameters
 
Burns and sudden death
Burns and sudden deathBurns and sudden death
Burns and sudden death
 
Empyema presentation
Empyema presentationEmpyema presentation
Empyema presentation
 
Calcium channel blockers
Calcium channel blockersCalcium channel blockers
Calcium channel blockers
 
Geriatrics health assessment
Geriatrics health assessmentGeriatrics health assessment
Geriatrics health assessment
 
Knee disorders
Knee disordersKnee disorders
Knee disorders
 
Ectopic pregnancy
Ectopic pregnancyEctopic pregnancy
Ectopic pregnancy
 
Lens and cataract
Lens and cataractLens and cataract
Lens and cataract
 

Recently uploaded

Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024
Torstein Dalen-Lorentsen
 
SENSORY NEEDS B.SC. NURSING SEMESTER II.
SENSORY NEEDS B.SC. NURSING SEMESTER II.SENSORY NEEDS B.SC. NURSING SEMESTER II.
SENSORY NEEDS B.SC. NURSING SEMESTER II.
KULDEEP VYAS
 
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International TravelersTravel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
NX Healthcare
 
Pharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and AntagonistPharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and Antagonist
Dr. Nikhilkumar Sakle
 
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptxPost-Menstrual Smell- When to Suspect Vaginitis.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
FFragrant
 
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)
Josep Vidal-Alaball
 
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfTest bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
rightmanforbloodline
 
Nano-gold for Cancer Therapy chemistry investigatory project
Nano-gold for Cancer Therapy chemistry investigatory projectNano-gold for Cancer Therapy chemistry investigatory project
Nano-gold for Cancer Therapy chemistry investigatory project
SIVAVINAYAKPK
 
Recent advances on Cervical cancer .pptx
Recent advances on Cervical cancer .pptxRecent advances on Cervical cancer .pptx
Recent advances on Cervical cancer .pptx
DrGirishJHoogar
 
Skin Diseases That Happen During Summer.
 Skin Diseases That Happen During Summer. Skin Diseases That Happen During Summer.
Skin Diseases That Happen During Summer.
Gokuldas Hospital
 
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticalsacne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
MuskanShingari
 
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấuK CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
HongBiThi1
 
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPromoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
PsychoTech Services
 
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
FFragrant
 
LOW BIRTH WEIGHT. PRETERM BABIES OR SMALL FOR DATES BABIES
LOW BIRTH WEIGHT. PRETERM BABIES OR SMALL FOR DATES BABIESLOW BIRTH WEIGHT. PRETERM BABIES OR SMALL FOR DATES BABIES
LOW BIRTH WEIGHT. PRETERM BABIES OR SMALL FOR DATES BABIES
ShraddhaTamshettiwar
 
DECLARATION OF HELSINKI - History and principles
DECLARATION OF HELSINKI - History and principlesDECLARATION OF HELSINKI - History and principles
DECLARATION OF HELSINKI - History and principles
anaghabharat01
 
Case presentation On Urinary tract infection
Case presentation On Urinary tract infectionCase presentation On Urinary tract infection
Case presentation On Urinary tract infection
KarthyAks1
 
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
MuskanShingari
 
How to Control Your Asthma Tips by gokuldas hospital.
How to Control Your Asthma Tips by gokuldas hospital.How to Control Your Asthma Tips by gokuldas hospital.
How to Control Your Asthma Tips by gokuldas hospital.
Gokuldas Hospital
 
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
June 2024 Oncology Cartoons By Dr Kanhu Charan PatroJune 2024 Oncology Cartoons By Dr Kanhu Charan Patro
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
Kanhu Charan
 

Recently uploaded (20)

Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024
 
SENSORY NEEDS B.SC. NURSING SEMESTER II.
SENSORY NEEDS B.SC. NURSING SEMESTER II.SENSORY NEEDS B.SC. NURSING SEMESTER II.
SENSORY NEEDS B.SC. NURSING SEMESTER II.
 
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International TravelersTravel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
 
Pharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and AntagonistPharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and Antagonist
 
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptxPost-Menstrual Smell- When to Suspect Vaginitis.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
 
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)
 
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfTest bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
 
Nano-gold for Cancer Therapy chemistry investigatory project
Nano-gold for Cancer Therapy chemistry investigatory projectNano-gold for Cancer Therapy chemistry investigatory project
Nano-gold for Cancer Therapy chemistry investigatory project
 
Recent advances on Cervical cancer .pptx
Recent advances on Cervical cancer .pptxRecent advances on Cervical cancer .pptx
Recent advances on Cervical cancer .pptx
 
Skin Diseases That Happen During Summer.
 Skin Diseases That Happen During Summer. Skin Diseases That Happen During Summer.
Skin Diseases That Happen During Summer.
 
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticalsacne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
 
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấuK CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
 
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPromoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
 
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
 
LOW BIRTH WEIGHT. PRETERM BABIES OR SMALL FOR DATES BABIES
LOW BIRTH WEIGHT. PRETERM BABIES OR SMALL FOR DATES BABIESLOW BIRTH WEIGHT. PRETERM BABIES OR SMALL FOR DATES BABIES
LOW BIRTH WEIGHT. PRETERM BABIES OR SMALL FOR DATES BABIES
 
DECLARATION OF HELSINKI - History and principles
DECLARATION OF HELSINKI - History and principlesDECLARATION OF HELSINKI - History and principles
DECLARATION OF HELSINKI - History and principles
 
Case presentation On Urinary tract infection
Case presentation On Urinary tract infectionCase presentation On Urinary tract infection
Case presentation On Urinary tract infection
 
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
 
How to Control Your Asthma Tips by gokuldas hospital.
How to Control Your Asthma Tips by gokuldas hospital.How to Control Your Asthma Tips by gokuldas hospital.
How to Control Your Asthma Tips by gokuldas hospital.
 
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
June 2024 Oncology Cartoons By Dr Kanhu Charan PatroJune 2024 Oncology Cartoons By Dr Kanhu Charan Patro
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
 

Urinary tract infections

  • 1. Urinary Tract Infections Mohammad Yahya Tailakh 5th year medical student University of Jordan
  • 2. What is UTI?  Inflammation of the urothelium due to microorganism invasion.  Urinary tract infection is a term that is applied to a variety of clinical conditions ranging from the asymptomatic presence of bacteria in the urine to severe infection of the kidney with resultant sepsis.  Clinical presentation:  The most frequent chief complaint related to urinary tract infection (UTI) is dysuria.  urinary frequency, and urgency are approximately 75% predictive for UTI.  acute onset of hesitancy, urinary dribbling, and slow stream are only approximately 33% predictive for it.
  • 4.
  • 5. Epidemiology  The incidence of true urinary tract infection (UTI) in adult males younger than 50 years is low (approximately 5-8 per year per 10,000), with adult women being 30 times more likely than men to develop a UTI. The incidence of UTI in men approaches that of women only in men older than 60 years.  in infants age group bacteriuria is more common in males while from 1-5 years its more common in females .  The causes of UTI in peds is commonly caused by congenital anomalies [reflux, obstruction]
  • 6. General Definitions  Recurrent UTI : more than 2 infections in 6 months or 3 infections in 1 year  Isolated UTI : more than 6 months between one infection and another.  Uncomplicated UTI : UTI in structurally and functionally (both) normal urinary tract with normal immunity and low risk of bacterial virulence ,majority are females  Complicated UTI : one of these or more present; male, pt with structurally or functionally abnormal kidney , immunocompromised , chance of increased bacterial resistant (hx of ABx use or hospitalization) , majority are males i.e if UTI occurred in a male its most likely to be complicated  Bacteriuria : significant amount of bacteria in urine >10^5ml. sym or asym [asym should be treated in :1-children 2- pregnancy 3- immunocompromised  Pyuria : presence of WBC in urine more than 5 HPF. /sterile! Without presence of bacteria.
  • 7. Pyelonephritis  • It means infection of the renal parenchyma and renal pelvis.  Risk factors : VUR, DM, pregnancy, congenital malformation , indwelling catheter, obstruction.
  • 8. Types : -Acute pyelonephritis -Chronic pyelonephritis -Emphysematous pyelonephritis -Xanthogranulomatous pyelonephritis
  • 9. Acute pyelonephritis  Presentation ranges from mild illness to sepsis, pt may be well or ill.  Signs and symptoms : loin pain, nausea, vomiting, fever, chills, rigor , may be associated with lower UTI symptoms, tachycardia , costovertebral angle tenderness  Histology : neutrophils infiltrates  M.c.c : ascending infection ; E.coli .  Can be also Hematogenous ,lymphatics spread.
  • 10. Investigation and treatment  Investigations: UA ,culture,CBC [leukocytosis ], KFT[creatinine].  Blood culture is preserved for immunocompromised patients  TREATMENT :  Out pt :oral flouroquinilone ,broad spectrum ABX .  In pt : IV flouroquinolone s &aminoglycosides  Urine culture should be repeated 1-2 wks after ABX.
  • 11. Criteria for admission to hospital: 1- extremes of age 2- complicated 3- persistent vomiting 4- failure out pt
  • 12. Clinical case  65 year old male, diabetic, with IHD came to the ER with bilateral flank pain ,fever, lower UTI symptoms , +ve renal angle and suprapubic tenderness,what to do ?  it's a complicated UTI until proven otherwise  Do CT scan without contrast  If stone is found then its an obstructive pyelonephritis which is a life threatening condition where pt may became shocked at anytime so Management will be with IV fluids , IV antibiotics send blood culture don't remove the stone at this time but it’s a must to relieve the obstruction by putting a uretric (double j) stent pr a nephrostomy tube , after pt stabilization manage to remove the stone
  • 13.
  • 14. Chronic pyelonephritis :  Recurrent pyelonephritis .  Causes : VUR ,chronic obstruction .  Histology : fibrosis  Signs and SX : asym to renal failure >. Fever, weight loss, nausea, vomiting, flank pain
  • 15.
  • 16. Emphysematous pyelonephritis :  DM  High mortality rate  Gas forming bacteria m.c.c : E.coli ,klabsella , proteus.
  • 17. Xanthogranulomatus pyelonephritis :  rare, serious, chronic inflammatory disorder of the kidney characterized by a destructive mass that invades the renal parenchyma.  XGP is most commonly associated with Proteus or Escherichia coli infection or Pseudomonas species.  XGP is characterized by lipid-laden foamy macrophages.  XGP shares many characteristics with true renal neoplasms in terms of its radiographic appearance and its ability to involve adjacent structures or organs  Risk factors : urinary tract obstruction, infection, nephrolithiasis, diabetes, and/or immunocompromise
  • 18.  The overall prognosis for XGP is good  CT scan shows renal calcification difficult to differentiate from CA  Treatment :is a surgically managed disease that is treated with either nephrectomy or, in rare circumstances, partial nephrectomy. Antibiotics are used in all cases, but medical care rarely suffices for treatment.
  • 19.
  • 20. Cystitis  Inflammation of the urinary bladder .  Most common organism : E.coli others : staph.saprophytics klebsiella,  honeymoon cystitis .  Types:  -acute infectious  -cystitis cystica and glandular cystitis Brunn’s nests that grow into lamina propria and are transformed into urothelium lining slitlike or cystic spaces with pink fluid  -follicular cystitis  - hemorrhagic  -interstitial
  • 21.  Signs and SX: suprapubic pain ,dysuria ,frequency ,urgency , offensive smelled urine, hematuria ,fever .  invX : UA,culture  TX : sulfamethoxazole
  • 22. Urethritis  Most common causative organism is neisseria gonorrhoea ,chlamydia .  Signs and SX : dysuria ,discharge , meatal and penile shaft pain  How ever ,no frequency or urgency .  => if Dysuria without frequency then its urethritis  gonococcal : present with sudden onset of large amount of yellow discharge and mild dysuria  non gonococcal : caused by clamydia trachomatis , present with gradual onset of clear discharge  Dx : urethral swab +culture .  TX : sefoloxime ,azithromycin
  • 23.
  • 24. Prostatitis  is swelling and inflammation of the prostate gland, Due to reflux of infected urine into prostatic duct.  5% prevalence  Risk factors : UTI, urethral catheter  M.c organism : Ecoli, proteus, klebsiella
  • 25. Classification : Acute bacterial prostatitis Chronic bacterial Chronic pelvic pain syndrome Asymptomatic inflammatory prostatitis (histologic)
  • 26. Acute prostatitis :  presentation is with lower urinary tract symptoms in the absence of loin pain and presence of fever (most imp distinguishing factor),  ttt is with broad spectrum ABx, it requires hospitalization, avoidance of urethral catheter, if needed use suprapubic catheter
  • 27. o Chronic prostatitis  Causes :Recurrent infection , trauma .  Sx : Painful bowel movement ,hematuria, painful voiding ,painful ejaculation  treatment is with NSAID, steroids, alpha blockers, alpha reductase inhibitors, if refractory to medical ttt microwave heat therapy
  • 28. chronic pelvic pain syndrome  is a pelvic pain condition in men, and should be distinguished from other forms of prostatitis ,also known as Chronic nonbacterial prostatitis  Signs and symptoms  lasting longer than 3 months. Symptoms may wax and wane. Pain can range from mild to debilitating. Pain may radiate to the back and rectum, making sitting uncomfortable. Pain can be present in the perineum, testicles, tip of penis, pubic or bladder area.[5] Dysuria, arthralgia, myalgia, unexplained fatigue, abdominal pain, constant burning pain in the penis, and frequency may all be present. Post-ejaculatory pain, mediated by nerves and muscles, is a hallmark of the condition.
  • 29. Causes  Nerves, stress and hormones  Food allergies  Climate