Infection Urinaire Past Notes PDF

## Infection urinaire. **Physiopathologie** * **Agents pathogènes:** * **BK:** E. coli, Proteus, MG * **Cocci:** Staphylococcus saprophyticus and aureus * **Candida** * **Voies de dissemination:** * Ascendante: 97% * Hématogène: Local renal of septicemia or bacteremia * **Facte...

## Infection urinaire. **Physiopathologie** * **Agents pathogènes:** * **BK:** E. coli, Proteus, MG * **Cocci:** Staphylococcus saprophyticus and aureus * **Candida** * **Voies de dissemination:** * Ascendante: 97% * Hématogène: Local renal of septicemia or bacteremia * **Facteurs favorisants:** * **Sexuelle:** Active sex, pregnancy, postmenopause * **Uropathie malformative:** * Urethral abnormalities: Circumcision * Obstruction: Prostatic pathology * **Urinary stasis:** Frequent urination, incomplete mictions, post miction residues, retentions, incomplete emptying * **Conditions associated with urinary stasis:** * DM, neuroleptic medications * Chronic bowel obstruction * Catheter, bladder dysfunction * **Anomalies of the urinary tract : anatomical or functional** * Lithiasis, RVU * **Severity** * **Simple IUs:** * Young patient * No history of urinary tract malformations * **At risk of complications** * **Severe IUs:** Sepsis, septic shock * **Clinical presentation:** * **Pollakiuria, burning micturition, imperative micturition, urinary retention, haematuria** **Clinical presentation** * **Cystitis** * **Simple:** * **Symptoms:** Frequent urination, burning sensation * **Treatment:** Bismuth * **Frequency:** 65% * **Recurrent:** * **Frequency:** > 4 episodes * **Reason for recurrent infections:** * **Urogenital malformation** * **Underlying disease** * **Risk:** * **Underlying disease or functional abnormalities** * **At-risk patients:** Pregnant woman * **Pyelonephritis** * **Symptoms:** * **Fever, chills** * **Unilateral flank pain** * **Tenderness in the lumbar region ** * **Signs of PNA** * **Evaluation:** * **Incomplete clinical presentation** * **Search for signs of gravity (septic shock) systematically** **Ju Masculines (Prostatitis, orchidepididymitis, PNA = Different PEC )** * **Factors favoring infection:** * **Underlying condition of the lower urinary tract (prostatitis)** **Clinical presentation** * **Symptoms that may indicate a poor prognosis:** * **Fever and chills** * **Lumbar pain** * **Prostatitis** * **Tenderness on palpation, firm prostate (prostatitis)** * **Hot scrotal sac (OE)** * **Asymptomatic bacteriuria** **Paraclinique** * **Urinalysis** * **Easy:** * **Detection of IUs** * **Does not exclude IUs** * **Sufficient for simple cystitis** * **Positive for nitrite reductase** * **Positive for leucocytes and nitrites** * **Negative for leucocytes and nitrites** * **Urine Culture** * **Required for diagnosis** * **Urine collected:** * **Fresh urine** * **Cleaned meatus** * **Midstream urine** * **First morning urination** * **1 hour after urination or 1 hour after catheterization** * **Sterile container** * **Fast transportation to the lab** * **Before any prescription of antibiotics** * **Not required for simple cystitis** * **Indications:** * **Second episode of infection** * **Systemic infection** * **Recurrent cystitis** * **Results:** * **Leucocytes:** > 10/mL * **Bacteriuria:** >10^3/mL * **Other germs:** * **Enterobacteria** * **Aerobic and anaerobic** * **Blood tests:** * **C-reactive protein:** * **Elevated in acute PNA, PINA** * **NFS:** * **Elevated in acute PNA, PINA** * **CRP:** * **Elevated in patients with unfavorable prognosis** * **Creatinine, urea** * **Evaluation of renal function** * **Imaging:** * **Ultrasound:** * **Evaluation of renal function** * **Shows renal dilation, abcesses** * **CT Scan:** * **Show renal dilation, abcesses** * **Dilatation in patients with renal dysfunction in the form of abscesses** **Treatment** * **Forfe-Trom (Fo)** * **Easy to administer** * **Preferred for treatment of urinary tract infections** * **Antibiotics** * **Choice of antibiotic depends on:** * **Severity of infection** * **Antibiogram** * **Selection of antibiotics:** * **Simple IUs:** * **Nitrofurantoin** * **Fosfomycin** * **Piumécillinam** * **Co-trimoxazole (Bactrim)** * **Duration:** For 7 days * **Follow-up:** * **Urine culture after treatment** * **Urine culture every month after delivery** * **Risk IUs:** * **Ciprofloxacin (Cipro)** * **Cefibime (Claboran)** * **Ceftriaxone (Rocephine)** * **Duration:** 14 days * **Severe IUs:** * **Aminoglycosides (Gentamicin)** * **Duration:** 21 days or until resolution of abscess ### Complication * **Kidney damage** * **Sepsis, septic shock** * **Renal abscess** * **Chronic interstitial nephritis, pyelonephritis** * **Renal failure** **NP/ NIC/ Hyonephros** ### **References: [URL to textbook]** **Disclaimer** *This information is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.*