Urinary Tract Infection: Difference between revisions
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Post-menopausal women present with constitutional symptoms, such as abdominal pain, back pain, chills, and constipation | Post-menopausal women present with constitutional symptoms, such as abdominal pain, back pain, chills, and constipation<ref name="Rowe" />. | ||
Nursing home patients present with nonspecific symptoms, such as confusion and a decline in functional status | Nursing home patients present with nonspecific symptoms, such as confusion and a decline in functional status <ref name="Rowe" />. | ||
Children are usually the hardest to diagnose due to the their vagueness of symptoms. The typical adult symptoms of frequency, urgency, and dysuria are usually absent in children. Young children sometimes present with irritability, poor feeding, vomiting, or jaundice. UTI should be considered in any child between two months and two years of age with fever that doesn't have an identifiable source of infection. [2] Young children with incontinence and abdominal pain should be checked for UTI. [2]<br> | Children are usually the hardest to diagnose due to the their vagueness of symptoms. The typical adult symptoms of frequency, urgency, and dysuria are usually absent in children. Young children sometimes present with irritability, poor feeding, vomiting, or jaundice. UTI should be considered in any child between two months and two years of age with fever that doesn't have an identifiable source of infection. [2] Young children with incontinence and abdominal pain should be checked for UTI. [2]<br> | ||
Revision as of 02:39, 24 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, WikiSysop, Nicole Hills, Elaine Lonnemann and Krista Polanin
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[1]. 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 [2] [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[2].
Alternative treatment includes the use of probiotics, ensuring proper hydration, drinking cranberry juice, and urinating frequently [2] [1] [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 [7]:
- Herpes genitalis (HSV)
- Urethritis
- N. Gonorrhoeae
- Chlamydia
- Trichomonas
- Vaginitis
- Prostatitis
- Nephrolithiasis
- Trauma
- GU tuberculosis
- GU neoplasm
- Intra-abdominal abscess
- Sepsis
Variation in symptom presentation:
Post-menopausal women present with constitutional symptoms, such as abdominal pain, back pain, chills, and constipation[2].
Nursing home patients present with nonspecific symptoms, such as confusion and a decline in functional status [2].
Children are usually the hardest to diagnose due to the their vagueness of symptoms. The typical adult symptoms of frequency, urgency, and dysuria are usually absent in children. Young children sometimes present with irritability, poor feeding, vomiting, or jaundice. UTI should be considered in any child between two months and two years of age with fever that doesn't have an identifiable source of infection. [2] Young children with incontinence and abdominal pain should be checked for 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
1. Rowe, TA, Juthani-Mehta, M. Urinary tract infection in older adults. Aging Health. 2013;9(5).
2. Becknell, B, Schober, M, Korbel, L, Spencer, JD. The Diagnosis, Evaluation and Treatment of Acute and Recurrent Pediatric Urinary Tract Infections. Expert Review of Anti-infective Therapy. 2015;13(1):81–90.
3. Souza, EL, Figueiredo, EM, Velloso, FB, Geo, MS. Physiotherapy For Women with Recurrent Urinary Tract Infection: A Promising Approach. International Continence Society. 2013:223.
4. Lima, NP, Cardim da Silva, GM, Park, M, Pires-Neto, RC. Mobility therapy and central or peripheral catheter-related adverse events on an ICU in Brazil. J bras pneumol. 2015;41(3):225–230.
5. Mody, L, Juhani-Mehtta, M. Urinary Tract Infections in Older Women: A Clinical Review. JAMA. 2014;311:844–854.
6. De Paepe, H, Hoebeke, P, Renson, C, et al. Pelvic-floor therapy in girls with recurrent urinary tract infections and dysfunctional voiding. British Journal of Urology. 1998;3:10–9113.
7. M, P, D, S. Adult UTI. Advancing Urology. Available at: www.auanet.org/education/adult-uti.cfm.
8. Rosenblum, N. Recurrent Urinary Tract Infections. Urology. Available at: http://www.med.nyu.edu/urology/patient-care-information/conditions-we-treat/recurrent-urinary-tract-infections
9. Urinary Tract Infections in Adults. Urologic Diseases. 2013. Available at: http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/urinary-tract-infections-in-adults/pages/ez.aspx.
10. Grabe, M. Guidelines on Urological Infections. Urological Infections. Available at: http://uroweb.org/wp-content/uploads/19-urological-infections_lr2.pdf.
