How to Identify Diagnosis of Lower Urinary Tract Infection
Upper urinary tract infection refers primarily to pyelonephritis, can be divided into acute pyelonephritis and chronic pyelonephritis two kinds. Lower urinary tract infections include cystitis, and urethritis. As the site of infection is different from recurrent nature, prognosis and treatment programs are different, so distinguish between the upper and lower urinary tract infection, that is, identifying the site of urinary tract infection has important significance.
Why should we identify the upper and lower urinary tract infection? Because the treatment of urinary tract infections, according to vary by the lesion.
Upper urinary tract infection (ureteritis, pyelonephritis) in elderly patients with bacteriuria and low blood pressure occurs easily, so it should be hospitalized, through the vein of antimicrobial drug treatment. Started in accordance with the results of Gram stain smears of bacteria drug selection. When the urine pathogens identified, it should immediately switch to sensitive drugs. Generally considered penicillin and Pioneer Class ADM adverse reactions caused by the elderly is relatively small. Pairs of elderly patients with acute pyelonephritis application is correct, sufficient quantities of antibiotic therapy 72 hours later, there is no improvement of symptoms of urinary tract obstruction should be considered and occurrence of renal or perirenal abscess possibilities. According to different situations to take treatment measures, such as ureteral obstruction caused by stones should take stone surgery; right perinephric abscess should be incision and drainage; right renal abscess should be a long-term antibiotic therapy, and occasionally require surgical incision and drainage and so on.
Lower urinary tract infection (urethritis, cystitis) the patient may not hospitalized, out-patient treatment, more use of short-term therapy (3 days or a single dose). Clinical practice tips, limitations of the female urinary tract infections in the bladder application of short-term efficacy of therapy in 7-14 days with the same efficacy of therapy. Using a single dose of ampicillin or cotrimoxazole Deng Jun effective. Older and better adaptability to the short course of treatment, and side effects and low cost. With typical symptoms of lower urinary tract infection in older women a better course of treatment with 3 days. Recurrence after cessation of treatment should be used 14 days of therapy, such as drug-resistant strains are still invalid will have to take into account and look for the original lesion. Patients who relapse on repeated low-dose antibiotics should be used long-term treatment. Low-dose vaginal estrogen to maintain a normal PH value, so the regular recurrence of urinary tract infection in elderly patients may have a role. Pairs of urethral obstruction caused by benign prostatic hyperplasia catheterization should be carried out.
How can we identify the upper and lower urinary tract infection? The traditional identification of the upper and lower urinary tract infection based on clinical symptoms and signs as the basis for identifying the site of infection. If only a urinary tract irritation and authenticity of bacteria in urine were considered to be cystitis; a urinary tract irritation, authenticity of bacteria in urine, kidney area pain tenderness and percussive, or accompanied by low back pain and fever were considered to be on the pyelonephritis. This method is convenient simple and practical.
However, the clinical, there are a lot of pyelonephritis in patients with frequent urination, urination discomfort mainly no other symptoms of urinary tract infection; cystitis can also occur in patients with low back pain and sometimes a small number of patients have low-grade fever. Therefore, clinical symptoms and signs alone is difficult to make a correct diagnosis position. This simple distinction between the upper and lower urinary tract infection clinical methods only reference, people wishing to make an accurate positioning diagnosis, must rely on laboratory tests.
Clinically, a more commonly used there is a method of identifying the following: The urinary frequency, urgency, dysuria syndrome mainly women of childbearing age, be thoroughly single-dose or 3 treatments, such as can cure, is more of cystitis ; such as the cessation of the treatment within a relapse in January (most of them in relapse within 1 to 2 weeks), then mostly pyelonephritis. This therapeutic method of positioning accuracy of up to 80%.
Category: Urinary Tract Infection
