Urinary Tract Infection 中國醫藥大學 附設醫院 感染科主任 王任賢

Urinary tract infection Pyelonephritis Renal, pararenal, & perirenal abscess Cystitis Prostatitis Epididymitis Urethritis

Acute pyelonephritis Pathogenesis ascending vs descending Pathogen ascending: E. coli >>P. mirabilis descending: S. aureus, GAS, Candida Clinical presentation fever + GI symptoms flank pain, frequency, urgency Diagnosis urine culture vs urine routine

Renal, pararenal, & perirenal abscess As a complication of chronic PN Metastatic infection location: trauma site, cortex border pathogen: S. aureus, GAS, Candida Clinical presentation flank pain >> GI symptoms

Cystitis DDx of upper UTI vs lower UTI Usual ascending infection Clinical presentation frequency, urgency >> GI symptoms less fever Short course antibiotics treatment

Urethritis Female vs male Clinical presentation discharge, micturation pain, meatus itching Diagnosis urethral discharge urethral smear: WBC>5/HPF Pathogen gonococcus, C. trachomatis

Prostatitis Acute prostatitis high fever + frequency, urgency Chronic prostatitis frequent relapsing UTI Diagnosis prostate massage post massage vs midstream urine

Epididymitis Clinical presentation unilateral scrotal swelling + fever Pathogenesis from cystitis from urethritis

TB kidney Descending infection Renal calcification Kaleidoscopic urinalysis Beaded ureter, contracted bladder, Golf hole Can involve testis

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