Urinary Tract Infections

Introduction

Urinary Tract Infections (UTI) lie among the most significant reasons for therapy in adult primary care medicine. It accounts for a considerable percentage of antibiotic prescriptions, and since the problem is so rampant and crucial in routine medical practice, it requires increased accuracy in diagnosis. Moreover, due to the increased reports of antibiotics resistance, health officials warn against prescribing antibiotics excessively. However, clinicians can use a few additional diagnostic criteria to provide antibiotic treatment for UTI more precisely and effectively. UTI affects various parts of the human body, is more prevalent among women, and the differential diagnosis comprises Pelvic pulmonary disease, Vaginitis, and Acute Pyelonephritis.

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Primary Diagnosis

UTI is an infection of any part of the urinary system, including the ureters, urethra, and the bladder kidneys. Women are at a higher risk of developing the infection than men since women have a shorter urethra than their male counterparts. It is, however, common among men aged 15 to 50 years who have unprotected anal sex. The risk factors for UTI include sexual intercourse, frequent use of antibiotics, history of UTIs among female relatives, experiencing a first UTI at an early age, diaphragm and spermicide use, and having a new sex partner within the past one year (Cai et al., 2018).   The primary diagnosis involves urine collection and testing. Other tests, mainly for seriously ill patients, require evaluation of for sepsis using CBC, electrolytes, BUN, and blood cultures. The condition is treatable using antibiotics and sometimes surgery to remove abscesses, rectify any abnormalities, or relieve the obstruction. Prevention measures, especially in women who experience three or more UTIs experience involve behavioral measures like taking more fluids, abstaining from the use of spermicides and diaphragm use, urinating more frequently, wiping from the front to back after defecation, and urinating immediately after engaging in sexual intercourse.

Differential Diagnosis

Pelvic Inflammatory Disease (PID)

PID is an infection and inflammation of the uterus, fallopian tube, ovaries, and cervix of a woman. It is caused by bacteria, is usually transmitted through sexual intercourse, and affects approximately one million women in the United States. Risk factors of PID include Douching, engaging in sexual intercourse with different people, especially for young women, and a history of PID in the family (Huang et al., 2019). Symptoms may include fever, pelvic pain, painful urination, vaginal discharge, or none at all.

Vaginitis

The condition is an inflammation of the vagina that is commonly caused by bacterial vaginosis. It occurs due to a change in the normal balance of the microorganisms that maintain the normal vaginal flora (Krishnasamy, Saikumar, & Kumaramanickavel, 2019). An example of factors that can alter the composition of the vaginal flora includes age. The symptoms of the disease include vaginal pain, pain during urination and sexual intercourse, vaginal irritation, abnormal vaginal discharge, and vaginal odor.

Acute Pyelonephritis

Acute Pyelonephritis is a severe kidney infection that causes a person’s kidneys to swell and may damage them permanently (Sanga Reddi et al., 2019). The condition can develop into chronic Pyelonephritis, especially in children or individuals with urinary obstructions. Its symptoms include fever, pain in the groin and abdomen, burning sensation when urinating, and smelly urine among other symptoms. Bacteria that enter the body and spread to the bladder cause the disease.

Conclusion

The urinary tract infection is a common disease that affects the reproductive organs, especially in women. The disease has a variety of differential diagnoses. Its treatment involves the use of a small number of diagnostic criteria, which makes the diagnostic more effective.

References

Cai, T., Mattevi, D., Luciani, L. G., Malossini, G., Lanzafame, P., Caciagli, P., … Bjerklund Johansen, T. E. (2018). Role of increasing leukocyturia for detecting the transition from asymptomatic bacteriuria to symptomatic infection in women with recurrent urinary tract infections: A new tool for improving antibiotic stewardship. International Journal of Urology, 25(9), 800–806.

Huang, C.-C., Huang, C.-C., Lin, S.-Y., Chang, C. Y.-Y., Lin, W.-C., Chung, C.-H., … Chien, W.-C. (2019). Association of pelvic inflammatory disease (PID) with ectopic pregnancy and preterm labor in Taiwan: A nationwide population-based retrospective cohort study. PLoS ONE, 14(8), 1–13.

Krishnasamy, L., Saikumar, C., & Kumaramanickavel, G. (2019). Aerobic Bacterial Pathogens causing Vaginitis in Patients Attending A Tertiary Care Hospital and their Antibiotic Susceptibility Pattern. Journal of Pure & Applied Microbiology, 13(2), 1169–1174.Sanga Reddi, B., Bodagala, V., Lakshmi, A., Kumar, N., & Kumar, V. (2019). Diffusion-weighted MR imaging in the diagnosis of acute pyelonephritis and its complications: A prospective observational study. Journal of Dr. NTR University of Health Sciences, 8(3), 170–174.

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