[Urinary tract infection in the diabetic patient]

Diabetic patients are said to be prone to infections. Several studies of different host defense mechanisms report defects in individual granulocyte functions and cell mediated immunity, especially in patients with poorly controlled diabetes. Diabetic females have an increased risk of developing urinary tract infections. This high susceptibility is probably due to local risk factors such as diabetic cystopathy and vaginitis, the latter being frequently associated with glucosuria. Urinary tract infections in diabetic individuals often have a complicated course which may be explained by the aforementioned compromised host defense mechanisms. Diabetics have an increased risk not only of lower, but also of upper urinary tract infections. Urinary tract infections such as emphysematous cystitis and pyelonephritis, as well as papillary necrosis as a complication of pyelonephritis, are not uncommon in diabetic patients. Rapid recognition and management of such complicated urinary tract infections is important.