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Urinary tract infections: Pathology review
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Two people came to the Nephrology ward.
The first one is 25 year old Carmen who recently returned from her honeymoon and now complains of suprapubic pain, dysuria and urinary frequency.
The other one is 35 year old Pamela who has had dysuria, fever, nausea and flank pain for the past 2 days.
On physical exam, she has costovertebral angle tenderness.
CBC and urinalysis were done for both people.
They showed that Carmen had a normal white blood cell count, but on the dipstick test, leukocyte esterase and nitrites were both positive.
For Pamela, the white blood count was high, the dipstick test showed positive leukocyte esterase and nitrites, and on microscopy, there’s white blood cell casts in the urine.
Urinary tract infections (UTIs) are common bacterial infections that can occur in any part of the urinary tract, including the kidneys, bladder, ureters, and urethra. They are most commonly caused by bacteria, such as E.coli, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus saprophyticus.
Symptoms include pain or burning sensation when urinating, frequent urge to urinate, cloudy or strong-smelling urine, pain or pressure in the lower abdomen or back, and in more severe cases, fever or chills.
Risk factors for UTIs include female gender, sex, diabetes mellitus, indwelling catheters, pregnancy, and kidney stones. Complications of untreated or recurrent UTIs can include cystitis, pyelonephritis, and sepsis. Treatment typically involves a course of antibiotics and plenty of fluids to help flush out the bacteria.
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