Infection in the patient with indwelling devices and ostomies

Urinary tract devices, often placed to alleviate obstruction or serve as support for surgical anastamosis, are used with increasing frequency. Although useful, they are fraught with hazards, especially infection. Infected devices have a myriad of clinical presentations that can be unrevealing or even misleading as to the underlying disease process. The astute clinician should maintain a high index of suspicion for such infections. Urinalysis alone has not been adequately studied to demonstrate that it alone can rule out infected foreign material in the urinary tract and should be followed by culture. Failure to recognize and treat infected urological hardware might lead to more rapid progression to ascending infection and more severe illness than expected in the absence of such devices.