In the name of God Bacterial infections of

In the name of God Bacterial infections of Urinary tract Tara Mottaghi Habibollah Amini Mazandaran University of Medical Sciences – Ramsar International Branch

Quick View § UTI Definition Imaging Treatment Recurrent UTI Approach to acute Cystitis § Renal Infections Acute Pyelonephritis Chronic Pyelonephritis Emphysematous Pyelonephritis Xanthogranulomatous Pyelonephritis Renal Abscess § Prostatitis § UTI during pregnancy § UTI in children

Urinary Tract Infection

Definition U/A Random urine samples Wbc > 10

Definition U/A Random urine samples Wbc > 10 U/C Mid stream urine samples + Dysuria & Frequency Colony count > 10²

Definition U/A Random urine samples Wbc > 10 U/C Mid stream urine samples + Dysuria & Frequency Mid stream urine samples + Asymptomatic urinary tract Colony count > 10² Colony count > 105

Definition U/A Random urine samples Wbc > 10 U/C Mid stream urine samples + Dysuria & Frequency Mid stream urine samples + Asymptomatic urinary tract Urine samples obtained by catheter Colony count > 10² Colony count > 105 Colony count > 10²

Definition U/A Random urine samples Wbc > 10 U/C Mid stream urine samples + Dysuria & Frequency Mid stream urine samples + Asymptomatic urinary tract Urine samples obtained by catheter Urine samples obtained through suprapubic aspiration Colony count > 10² Colony count > 105 Colony count > 10² A number of gramnegative bacteria

Definition U/A Random urine samples Wbc > 10 U/C Mid stream urine samples + Dysuria & Frequency Mid stream urine samples + Asymptomatic urinary tract Urine samples obtained by catheter Urine samples obtained through suprapubic aspiration Colony count > 10² Colony count > 105 Colony count > 10² A number of gram-negative bacteria A few gram-positive bacteria

Imaging ü KUB ü IVP ü Sonography ü CT Scan

Treatment for 3 -5 days Simple uncomplicated UTI in women Treatment for 7 days ü Thesigns and symptoms been persist for more than a week ü Age > 65 yrs ü History of diabetes ü Cystitis in pregnant ü Recent UTI

Recurrent UTI ü Reinfection ü Persistant ü Unresolved Causes • Chronic protatitis • Urinary fistulas • Infectious stones • Congenital anomalies of the urinary • Chronic pyelonephritis • Foreign body • Diverticulitis urethra • Ureteral stump after nephrectomy • Bacterial resistance to antibiotics used • The creation of resistant strains during treatment • Renal failure • Renal abscess • Staghorn renal calculi • Obstruction in the urinary tract • Inadequate dose treatment • Inadequate treatment period

Staghorn renal calculi

Pyelonephritis

Acute pyelonephritis Pyelonephritis Chronic pyelonephritis Emphysematous Pyelonephritis Xanthogranulomatous Pyelonephritis ü Fever Common sign & symptom : üShaking chills (Except chronic pyelonephritis) ü Flank pain ü Nausea & vomiting

Acute pyelonephritis • Fever • Shaking chills • Flank pain § Signs & symptoms : • Dysuria • Frequency • Cloudy urine • Vomiting • Pyuria § Laboratory tests results : • Hematuria • high ESR and CRP levels • Leukocytosis § The most common cause : Ecoli

Chronic pyelonephritis