Epidemiology:1. it is a very common problem affecting all age groups of patients.2. Women are more affected than men:anatomical & bacteriological
Urinary tract infections
M:F Ratio
percentage
Age group
1.5 : 1
1 %
Neonatal
1 : 10
1-2 %
Pre- school age
1 : 30
1 -2 %
School age
1 : 30
2 -5 %
Reproductive age
1 :5
20 – 30 %
Elderly age
Are equal
• 20 – 30 %
Over 65 years of age
Etiology & pathology
Mode of entry:• Ascending.
• Hematogenous.
• Direct extension.
• Urinary pathogens:
• are m.o. virulent enough to cause infections in the absence of abnormalities in urinary tract.
• Gram –ve group is the most common, E coli is the main responsible one ( 90% in hospital ).
• ( 50% in outside hospital ) the rest are made by;
• Kiebsiella, proteius, pseudomononas, Enterobacter
Predisposing factors for UTI
• Obstruction & urinary stasis.• Diabetes; 3 X > normal.
• Calculi.
• Foreign bodies.
• Elderly.
• Pregnancy.
Acute pyelonephritis
A cute bacterial invasion of the kidney & it is parenchymae.
1. F > M.
2. It affect children, at puberty, soon after marriage ( honey moon cystitis), during pregnancy, during menopause and
Elderly.
3. Rt side is > than Lt side.
Symptoms & signs:
A. Aprodromal phase;
• Nausea, vomiting, headache.
• Sudden onset of pain is common. At loin, or it may radiate to hypochondrium
• Fever ( 38.8 – 39.9 C) & rigor, patient looks sweaty, vomiting & thirsty
• imitative symptoms; dysuria, frequency, urgency.
• In severe cases temp (40C) repeated rigors, exclude obstruction
• O E : tender renal angle, loin & hypochondrium.
Lab.: GUE & C&S, RFT, CBP, & ESR, FBS,
Medical imaging study: US, KUB, IVU, MRI, CTTreatment
Investigations: