Urinary tract infection in adults

Urinary tract infection (UTI) Childhood UTI: OHCS p174

Definitions

• Bacteriuria: Bacteria in the urine, may be asymptomatic or symptomatic.
• UTI: The presence of a pure growth of >105 organisms per mL of fresh MSU.
• UTI sites:
• urethra (urethritis),
• bladder (cystitis),
• prostate (prostatitis), or
• renal pelvis pyelonephritis).
• Up to ? of women with symptoms have bacteriuria; (=abacterial cystitis or the urethral syndrome).

Renal biopsy

Most acute renal failure is due to pre-renal causes or acute tubular necrosis, and recovery of renal function typically occurs over the course of a few weeks.

Renal biopsy should be performed only if knowing histology will influence management.

Once chronic renal failure is established, the kidneys are small, there is a higher risk of bleeding from biopsy, and the results are usually unhelpful.

Renal disease and clinical syndromes

Typically presents with one or more of rather a short list of clinical syndromes—listed from 1 to 7 below.

One underlying pathology may have a variety of clinical presentations.

Renal medicine/ nephrology

Renal syndromes:

• proteinuria and nephrotic syndrome,
• haematuria and nephritic syndrome,
• renal pain and dysuria,
• oliguria and polyuria,
• acute renal failure,
• chronic renal failure or chronic kidney disease,
• silence

Urine tests

• urine dipstick
• mid stream urine

Renal biopsy

Urinary tract infection