Urinary tract infection

Chapter 36 Urinary tract infection



Chapter contents


Lower urinary tract 281

Benign prostatic hyperplasia (BPH) 282

Prostate cancer 283

Prostatitis 283

Urinary stones 283

Renal cancer 284

Bladder cancer 284


Lower Urinary Tract


Infections include:


• Cystitis.

• Urethritis.

More common in females. Common pathogens are Escherichia coli, Pseudomonas spp., Streptococcus spp., Staphylococcus spp.



Signs and Symptoms



• Urinary frequency.

• Dysuria.

• Suprapubic pain and tenderness.

• Haematuria.

• Smelly, cloudy urine.

These conditions are the ones most commonly seen by complementary healthcare practitioners. More serious upper urinary tract conditions, such as glomerulonephritis or pyelonephritis, are more likely to refer themselves directly to orthodox medical care. It is worth noting, however, that a relatively straightforward cystitis or urethritis can develop into an upper urinary tract condition if not treated appropriately.



Investigations



• Midstream urine sample is cultured.

Very often, a broad-spectrum antibiotic is given without a sample being taken, but if the infection does not clear then a culture needs to be grown to identify the type of bacteria and the most effective antibiotic for that strain.



Treatment



• A short course of antibiotics (see Chapter 29 ‘Antimicrobials’, p. 219).

• Plenty of water.

• Paracetamol or ibuprofen to ease symptoms.


Benign Prostatic Hyperplasia (BPH)



• Common in men over 50 years old.

• Urinary frequency and urgency with decreased urinary flow.

• Nocturia.

• Complications: infection due to the incomplete emptying of the bladder.


Laboratory Tests


The prostate-specific antigen (PSA) is elevated with a large benign prostate. Whether this level indicates a more pathological condition, i.e. malignant prostate, depends on the age group.



• PSA Levels



• Under 50 years of age: below 2.5 ng/mL.

• Under 60 years of age: below 3.5 ng/mL.

• Under 70 years of age: below 4.5 ng/mL.
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Jul 22, 2016 | Posted by in PHARMACY | Comments Off on Urinary tract infection

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