Urinary tract infection: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
The best [[symptom]]s and [[physical examination]] findings for diagnosis have been identified in a [[systematic review]] by the [http://sgim.org/index.cfm?pageId=666 Rational Clinical Examination].<ref name="pmid12020306">{{cite journal |author=Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S |title=Does this woman have an acute uncomplicated urinary tract infection? |journal=JAMA |volume=287 |issue=20 |pages=2701–10 |year=2002 |pmid=12020306 |doi= |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=12020306 |issn=}}</ref> | The best [[symptom]]s and [[physical examination]] findings for diagnosis have been identified in a [[systematic review]] by the [http://sgim.org/index.cfm?pageId=666 Rational Clinical Examination] in 2002.<ref name="pmid12020306">{{cite journal |author=Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S |title=Does this woman have an acute uncomplicated urinary tract infection? |journal=JAMA |volume=287 |issue=20 |pages=2701–10 |year=2002 |pmid=12020306 |doi= |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=12020306 |issn=}}</ref> | ||
Regarding symptoms, a subsequent study and [[clinical prediction rule]] found the best findings are urine cloudiness, offensive smell, moderately severe dysuria, moderately severe nocturia.<ref name="pmid19364448">{{cite journal| author=Little P, Turner S, Rumsby K, Warner G, Moore M, Lowes JA et al.| title=Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study. | journal=Health Technol Assess | year= 2009 | volume= 13 | issue= 19 | pages= iii-iv, ix-xi, 1-73 | pmid=19364448 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19364448 | doi=10.3310/hta13190 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19794030 Review in: Evid Based Med. 2009 Oct;14(5):155] <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
A subsequent study and [[clinical prediction rule]] showed the best predictors were urinary nitrite, leucocyte esterase and blood.<ref name="pmid19364448">{{cite journal| author=Little P, Turner S, Rumsby K, Warner G, Moore M, Lowes JA et al.| title=Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study. | journal=Health Technol Assess | year= 2009 | volume= 13 | issue= 19 | pages= iii-iv, ix-xi, 1-73 | pmid=19364448 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19364448 | doi=10.3310/hta13190 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19794030 Review in: Evid Based Med. 2009 Oct;14(5):155] <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
Urinary tract infections may be overdiagnosed in [[geriatrics|geriatric]] patients.<ref name="pmid19054190">{{cite journal |author=Woodford HJ, George J |title=Diagnosis and Management of Urinary Tract Infection in Hospitalized Older People |journal=J Am Geriatr Soc |volume= |issue= |pages= |year=2008 |month=November |pmid=19054190 |doi=10.1111/j.1532-5415.2008.02073.x |url=http://dx.doi.org/10.1111/j.1532-5415.2008.02073.x |issn=}}</ref> | Urinary tract infections may be overdiagnosed in [[geriatrics|geriatric]] patients.<ref name="pmid19054190">{{cite journal |author=Woodford HJ, George J |title=Diagnosis and Management of Urinary Tract Infection in Hospitalized Older People |journal=J Am Geriatr Soc |volume= |issue= |pages= |year=2008 |month=November |pmid=19054190 |doi=10.1111/j.1532-5415.2008.02073.x |url=http://dx.doi.org/10.1111/j.1532-5415.2008.02073.x |issn=}}</ref> | ||
Revision as of 21:19, 7 October 2009
In medicine, urinary tract infections are "inflammatory responses of the epithelium of the urinary tract to microbial invasions. They are often bacterial infections with associated bacteriuria and pyuria."[1]
Classification
More common types of urinary tract infections in include:
Cause
Males
In males, urinary tract infections are usually secondary to an underlying cause such as benign prostatic hyperplasia or genitourinary instrumentation.[2] However, a single episode is unlikely to be due to a serious underlying cause.[3]
Diagnosis
The best symptoms and physical examination findings for diagnosis have been identified in a systematic review by the Rational Clinical Examination in 2002.[4]
Regarding symptoms, a subsequent study and clinical prediction rule found the best findings are urine cloudiness, offensive smell, moderately severe dysuria, moderately severe nocturia.[5]
A subsequent study and clinical prediction rule showed the best predictors were urinary nitrite, leucocyte esterase and blood.[5]
Urinary tract infections may be overdiagnosed in geriatric patients.[6]
References
- ↑ Anonymous (2024), Urinary tract infection (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Lipsky BA (January 1989). "Urinary tract infections in men. Epidemiology, pathophysiology, diagnosis, and treatment". Ann. Intern. Med. 110 (2): 138–50. PMID 2462391. [e]
- ↑ Abarbanel J, Engelstein D, Lask D, Livne PM (July 2003). "Urinary tract infection in men younger than 45 years of age: is there a need for urologic investigation?". Urology 62 (1): 27–9. PMID 12837416. [e]
- ↑ Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S (2002). "Does this woman have an acute uncomplicated urinary tract infection?". JAMA 287 (20): 2701–10. PMID 12020306. [e]
- ↑ 5.0 5.1 Little P, Turner S, Rumsby K, Warner G, Moore M, Lowes JA et al. (2009). "Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study.". Health Technol Assess 13 (19): iii-iv, ix-xi, 1-73. DOI:10.3310/hta13190. PMID 19364448. Research Blogging. Review in: Evid Based Med. 2009 Oct;14(5):155
- ↑ Woodford HJ, George J (November 2008). "Diagnosis and Management of Urinary Tract Infection in Hospitalized Older People". J Am Geriatr Soc. DOI:10.1111/j.1532-5415.2008.02073.x. PMID 19054190. Research Blogging.