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Urinary Tract Infection II: Pathophysiology

Urinary Tract Infection II: Pathophysiology

The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...

Urine Studies II: Urine Culture and Sensitivity Test

Urine Studies II: Urine Culture and Sensitivity Test

A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...

Acute Pyelonephritis II: Diagnostic Studies and Management

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...

Acute Pyelonephritis I: Introduction

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...

Urinary Tract Infection I: Introduction

Urinary Tract Infection I: Introduction

Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...

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Persistent sterile pyuria in children? Don't forget tuberculosis!

L W Chiang¹, A S Jacobsen, C L Ong

¹Department of Paediatric Surgery, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899. chiang.li.wei@singhealth.com.sg

Singapore Medical Journal

|April 30, 2010

Summary

Genitourinary tuberculosis is rare in children. Early diagnosis of this condition in pediatric patients with atypical urinary tract infections is crucial to prevent kidney damage.

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Area of Science:

Pediatric Nephrology
Infectious Diseases
Urology

Background:

Genitourinary tuberculosis (GUTB) is a rare condition in the pediatric population.
Atypical urinary tract infections (UTIs) in children warrant thorough investigation.

Observation:

A 10-year-old girl presented with recurrent sterile pyuria and an obstructed left renal drainage system.
Initial renal investigations failed to identify the cause of the obstruction.

Findings:

Computed tomography suggested renal tuberculosis.
Urine acid-fast bacilli culture confirmed the diagnosis of genitourinary tuberculosis.
Left nephroureterectomy was necessary due to declining kidney function.

Implications:

Highlights the importance of considering GUTB in pediatric patients with atypical UTIs.
Emphasizes that early diagnosis of renal tuberculosis can prevent long-term renal impairment.
Underscores the need for comprehensive diagnostic approaches in pediatric urogenital conditions.