Lower Urinary Tract Infection: Pathogenesis and Clinical Findings
- Predisposing Factors: Immunocompromised state, diabetes, elderly, female (short urethra), stagnant urine (anatomical variant, obstruction, neurogenic bladder, urinary reflux) -> Impairment of body's natural defense systems, or stagnant urine, allow for bacterial accumulation
- Bacterial entry (Less Common): Indwelling catheter, surgical inoculation, hematogenous spread, trauma (Staphylococcus, Enterococcus, Candida) -> Portal of entry bypasses body's physical defenses (gravity and repetitive outward urine flow)
- Fecal bacteria access urethra (E. coli, Proteus, Klebsiella) -> Bacterial fimbriae and pili allow them to ascend urethra and adhere to epithelium
-> Lower Urinary Tract Infection ("Cystitis"): Infection of bladder or distal tract by capable bacteria colonizing epithelium and causing symptoms
Signs/Symptoms:
- Urgency: Sensation of need to urinate quickly or impending incontinence
- Frequency: Repetitive need to urinate
- Dysuria
- Fever, Malaise, Incr WBC (Rare in LUTI)
- Suprapubic Tenderness
- Urine Findings:
Incr Colony Count (>107 CFU/L)
Incr WBC (>10 WBC/gL)
(+) Bacterial culture
(+) Nitrites, Leukocyte Esterase
(+) Foul, turbid urine +/- Hematuria (rare)
#Lower #UrinaryTractInfection #LUTI #Pathophysiology #Signs #Symptoms
