Severe and complex urinary tract infections

This patient has a severe urinary tract infection requiring hospital admission.4 In addition to fever and flank tenderness, she has signs of possible sepsis with hypotension, rapid heart and respiratory rates, and mental clouding. Furthermore, her diabetes is out of control. Based on her clinical presentation, she has upper urinary tract disease (kidney, renal pelvis, or ureter) otherwise known as pyelonephritis. Because this woman is diabetic, she is by definition presenting with a complicated...

Diagnosis of STI

Sexually transmitted pathogens cause several common syndromes. Infection with Neisseria gonorrhoea or Chlamydia trachomatis frequently results in urethritis, cervicitis, or the constellation of symptoms and signs that suggest the presence of pelvic inflammatory disease. HSV, Treponema pallidum, and Haemophilus ducreyi are common agents of ulcerative genital disease, while vaginal discharge is commonly caused by infection with Trichomonas vaginalis or Candida spp. or by bacterial vaginosis....

References

Foxman B, Barlow R, D'Arcy H, Gillespie B, Sobel JD. Urinary tract infection self-reported incidence and associated costs. Ann Epidemiol 2000 10 509-15. 2. Kunin CM. An overview of urinary infections. In Kunin CM, ed, Urinary Tract Infections Detection, Prevention and Management, 5th edn, Baltimore Williams Wilkins, 1997. 3. Hooton TM, Scholes D, Hughes JP et al. A prospective study of risk factors for symptomatic urinary tract infection in young women. N Engl J Med 1996 335 468. 4. Bent S,...

Case presentation 2 continued

The patient's CSF PCR for HSV is positive and she completes a 14-day course of intravenous acyclovir. She has a slow recovery over several weeks with no clinical evidence of relapse and is transferred to a rehabilitation facility. Six months after the encephalitis, she is living independently but functioning at a lower level than previously and has short-term memory impairment and anosmia. 13. Durand ML, Calderwood SB, Weber DJ, et al. Acute bacterial meningitis in adults. A review of 493...

Urinary tract infections in men

A 40-year-old man presented to his physician with a 3-day history of dysuria. The pain was moderately severe but only present during voiding. He had no urethral discharge and he had no pelvic pain. He had not been sexually active for over 1 month prior to his dysuria. On examination, his temperature was 37-4 C and the general physical exam was normal. The rectal examination showed a mildly enlarged but non-tender prostate. Urine analysis showed pyuria and bacteriuria. Urine culture was obtained...

Cellulitis

Cellulitis is a common problem in primary care but only a minority are referred to consultants or admitted for inpatient treatment. A review of a patient database in five urban hospitals showed 3929 diagnoses of cellulitis representing 1-3 of Emergency Department visits 7 required inpatient treatment.1 Cellulitis usually presents with pain, erythema with typically indistinct borders and swelling. Fever and regional lymphadenitis are occasionally seen. In a predominately outpatient population,...