Urinary tract infection UTI dr,mohamed fawzi alshahwani

Urinary tract infection Specific tuberculosis belhareziasis Non specific pyelonephritis pyonephrosis renal abscess perirenal abscess

UTI UTI is an inflammatory response of the urothelium to bacterial invasion is an inflammatory response of the urothelium to bacterial invasion Bacteriuria Bacteriuria the presence of bacteria in the urine. the presence of bacteria in the urine. Pyuria Pyuria the presence of white blood cells (WBCs) in the urine the presence of white blood cells (WBCs) in the urine

Uncomplicated UTIUncomplicated UTI infection in a healthy patient with a structurally and functionally normal urinary tract. infection in a healthy patient with a structurally and functionally normal urinary tract. Complicated UTIComplicated UTI infection is associated with factors that increase the chance of acquiring bacteria and decrease the efficacy of therapy.. infection is associated with factors that increase the chance of acquiring bacteria and decrease the efficacy of therapy..

Ascending Route. Hematogenous Route. Lymphatic Route. Direct extension. Urinary Pathogens. E. coli is by far the most common cause of UTIs, accounting for 85% of community-acquired and 50% of hospital-acquired infections.

Acute Pyelonephritis is defined as inflammation of the kidney and renal pelvis, and its diagnosis is usually made clinically clinical picture Patients present with loin pain,chills, fever, and costovertebral angle pain, tenderness. nausea and vomiting, Sepsis may occur.

Investigations GUE WBCs and red blood cells,bacteria blood analysis Leukocytosis and increased ESR are commonly seen Urine for culture and sensitivity Ultrasound to detect any complicating factor like obstruction or stone CT and MRI provide the best anatomic data on the site,cause, and extent of infection.

depends on the severity of the infection In patients who have toxicity because of associated septicemia, obstruction or azotemia,hospitalization is warranted. Parenteral therapy should be maintained until the patient become a febrile Empiric therapy with intravenous ampicillin and aminoglycosides, or 2 nd generation cephalosporins is effective against a broad range of uropathogens Parenteral therapy should be maintained until the patient become a febrile,

. If bacteremia is present, parenteral therapy should be continued for an additional 7–10 days and then the patient should be switched to oral treatment for 10–14 days If bacteremia is present, parenteral therapy should be continued for an additional 7–10 days and then the patient should be switched to oral treatment for 10–14 days In patients who are not severely ill, outpatient treatment with oral antibiotics is appropriate. For adults, treatment with fluoroquinolones or TMP-SMX is well tolerated and effective. Therapy should continue for 10–14 days. In patients who are not severely ill, outpatient treatment with oral antibiotics is appropriate. For adults, treatment with fluoroquinolones or TMP-SMX is well tolerated and effective. Therapy should continue for 10–14 days.

Emphysematous pyelonephritis Emphysematous pyelonephritis is an acute necrotizing parenchymal and perirenal infection caused by gas-forming uropathogens. is an acute necrotizing parenchymal and perirenal infection caused by gas-forming uropathogens. About 80–90% of patients have diabetes; the rest of the cases are associated with urinary tract obstruction. About 80–90% of patients have diabetes; the rest of the cases are associated with urinary tract obstruction. Almost all patients display the classic triad of fever, vomiting, and flank pain. Almost all patients display the classic triad of fever, vomiting, and flank pain. Pneumaturia is absent unless the infection involves the collecting system. Pneumaturia is absent unless the infection involves the collecting system.

o E. coli is most commonly identified. Klebsiella and Proteus are less common. o The overall mortality rate between %. o Emphysematous pyelonephritis is a surgical emergency. Most patients are septic, fluid resuscitation and broad-spectrum antimicrobial therapy are essential.

If the kidney is functioning, medical therapy can be considered.. Nephrectomy is recommended for nonfunctioning kidney and for patients who do not improve after a few days of therapy.

Xanthogranulomatous Pyelonephritis is a rare, severe, chronic renal infection typically resulting in diffuse renal destruction. is a rare, severe, chronic renal infection typically resulting in diffuse renal destruction. Most cases are unilateral and result in a nonfunctioning, enlarged kidney Most cases are unilateral and result in a nonfunctioning, enlarged kidney usually associated with obstructive uropathy secondary to nephrolithiasis. usually associated with obstructive uropathy secondary to nephrolithiasis.