Urinary Tract Infection: Difference between revisions
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*Sepsis [7] | *Sepsis [7] | ||
In post-menopausal women | In post-menopausal women present with nonspecific generalized symptoms, such as lower abdominal pain, back pain, chills and constipation | ||
In nursing home patients are more likely to present with nonspecific symptoms, such as anorexia, confusion and a decline in functional status; fever may be absent or diminished | |||
In children is the inconsistent nature and vagueness of the presenting illness. Additionally, children often have a difficult time articulating their ailments and symptoms. The symptoms of frequency, urgency, and dysuria that are highly suggestive of UTI in an adult are often absent in children. Young children with UTI can present with irritability, poor feeding, vomiting, failure to thrive, or jaundice. UTI be considered in any infant or child between two months and two years of age presenting with fever without an identifiable source of infection [2]<br>In toddlers and young children, regression to incontinence in previously toilet-trained children and significant abdominal pain should raise suspicion for UTI. Suprapubic tenderness and presence of fever for more than two days are also strong predictors of UTI. [2]<br> | |||
In children | |||
== Case Reports/ Case Studies == | == Case Reports/ Case Studies == |
Revision as of 04:03, 22 March 2016
Original Editors - Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Top Contributors - Kaylee Whitehead, Melanie Anderson, Cate Hurst, Kim Jackson, Lucinda hampton, Vidya Acharya, Temitope Olowoyeye, Elaine Lonnemann, Krista Polanin, WikiSysop and Nicole Hills
Definition/Description[edit | edit source]
Prevalence[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
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Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
Urinary Tract infections that are left untreated may lead to many complications, including urosepsis, systemic inflammatory response syndrome (SIRS), and chronic kidney infections. Sepsis associated with UTIs often requires hospitalization [5]. Urosepsis spreads into the bloodstream from its origin in the urinary tract. Kidney infections also progress to the blood stream, referred to as septicemia [9]. This complication can be life threatening. Systemic inflammatory response syndrome can also become life threatening if treatment fails. SIRS is usually the first incidence of multi-organ failure [10].
Medical Management (current best evidence)[edit | edit source]
Urinary tract infections are most commonly treated by antibiotic prescription. Frequently prescribed antibiotics include [8]:
- Nitrofurantoin
- Amoxicillin
- Trimethoprim
- Fluoroquinolones
Antibiotics are usually taken anywhere from 3 days to 10 days, depending on severity of symptoms, comorbidities, complications of infection, and dosage [1] [8]. Overutilization of antibiotics is a common issue, particularly in hospitals and long term facilities, which may cause patients to develop resistance to the medication over time [1].
Alternative treatment includes the use of probiotics, ensuring proper hydration, drinking cranberry juice, and urinating frequently [2] [5] [9]. Using a heating pad on the patient’s lower back or abdomen may also help the symptoms of the UTI [9]. Surgery may be required in the presence of an anatomical abnormality [8].
Physical Therapy Management (current best evidence)[edit | edit source]
Physical therapists that are trained in pelvic floor dysfunction can greatly improve a UTI patient’s quality of life. A typical approach includes manipulative techniques, local heat, breathing and relaxation techniques, postural education, muscle coordination reeducation, and behavioral therapy [3]. Therapists are also encouraged to educate the patient on drinking and voiding schedules to ensure consistency [6]. Treatments and patient education have been found to improve efficiency of emptying the bladder, create better bowel habits, and promote full relaxation of the pelvic-floor when voiding [3]. All of these factors may lead to a decreased incidence and reoccurrence of UTIs.
For those patients in the hospital, recent studies have shown that mobilization of patients with a catheter is safe and is not associated with urinary-related adverse effects, including urinary tract infections [4].
Differential Diagnosis[edit | edit source]
Other conditions that can cause symptoms similar to UTI include:
- Herpes genitalis (HSV)
- Urethritis
- N. Gonorrhoeae
- Chlamydia
- Trichomonas
- Vaginitis
- Prostatitis
- Nephrolithiasis
- Trauma
- GU tuberculosis
- GU neoplasm
- Intra-abdominal abscess
- Sepsis [7]
In post-menopausal women present with nonspecific generalized symptoms, such as lower abdominal pain, back pain, chills and constipation
In nursing home patients are more likely to present with nonspecific symptoms, such as anorexia, confusion and a decline in functional status; fever may be absent or diminished
In children is the inconsistent nature and vagueness of the presenting illness. Additionally, children often have a difficult time articulating their ailments and symptoms. The symptoms of frequency, urgency, and dysuria that are highly suggestive of UTI in an adult are often absent in children. Young children with UTI can present with irritability, poor feeding, vomiting, failure to thrive, or jaundice. UTI be considered in any infant or child between two months and two years of age presenting with fever without an identifiable source of infection [2]
In toddlers and young children, regression to incontinence in previously toilet-trained children and significant abdominal pain should raise suspicion for UTI. Suprapubic tenderness and presence of fever for more than two days are also strong predictors of UTI. [2]
Case Reports/ Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
Physiotherapy For Women With Recurrent Urinary Tract Infection: A Promising Approach
Pelvic floor therapy in girls with recurrent UTIs
Resources
[edit | edit source]
American Urological Association
http://www.auanet.org/education/adult-uti.cfm
NYU School of Medicine Department of Urology
http://www.med.nyu.edu/urology/patient-care-information/conditions-we-treat/recurrent-urinary-tract-infections#diagnosis
European Association of Neurology
http://uroweb.org/wp-content/uploads/19-Urological-infections_LR2.pdf
Choices in Health
http://choicespc.net/physical-therapy-for-urinary-problems-and-pelvic-floor-dysfunction/
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
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Australian Institute of Sport and the Australian Paralympic Committee position statement: urinary tract infection in spinal cord injured athletes
http://bjsm.bmj.com.libproxy.bellarmine.edu/content/49/19/1236.full
References[edit | edit source]
see adding references tutorial.