Question

Urinary Tract Infections and Sexually Transmitted Infections:

1. A 20-year-old woman attending college experiences increasing urinary frequency, along with urgency and dysuria for 2 days. Over the next 12 hours or so, these symptoms persist and her urine is pink or bloody. She then becomes concerned and goes to the campus student health clinic for advice. Her vital signs are normal with the only abnormal finding on physical examination being a mild tenderness to deep palpation in the suprapubic area. No genital ulcers are noted and there is no vaginal discharge. The patient has no previous history of similar complaints.
   

1. What points to a diagnosis of a urinary tract infection in the woman?

2. What tests should be carried out to confirm this diagnosis?

3. How do infections like the one seen in this patient usually get started? What is the likely source of the causative microbe?

4. What are the human body's natural defenses against urinary tract infections like this one?

What are some differences between uncomplicated and complicated urinary tract infections? What are some factors that make people susceptible to complicated infections?

Answer 1

A) In the above condition there is increased urinary frequency, urgency, and dysuria.. And on deep palpation there is suprapubic pain this indicates that there is inflammation of urinary bladder due to urinary tract infection.

B) To diagnose the causative organism and confirm it as urinary tract infection we need to perform urine culture.. To perform urinary culture we need to collect the mid stream urinary sample.. On collection of urinary sample we need to examine for presence of any cast cells, Wbc, Rbc, staining and culture of urine for microorganisms.

C) In females urinary tract infections are more common because when compared to males they have short course of urethra and in women there is short distance between the anal opening and urethral opening so there will be easy spread of microbacterium.. And in young sexually active women there may be spread of microorganisms from her male partner.

Most common causative organism for urinary tract infection is E. Coli. Staphylococcus saprophyticus, klebsiella, neisseria, chlamydia..

Pink or red coloured urine can seen due to presence of stones in bladder or ureters.. Or any bladder malignancy..

D) The natural defences against UTI are basically when there is accumulation of urine in bladder there will be growth of organisms.. But this organisms can't spread into ureters or kidney due to presence of bends in ureter.. Presence of ureterovesicle reflex..basically UTI can be due to ascending tract infection and descending tract infection(from blood).. In some patients there will be short uretero vesical Junction.. Absence of protective reflexes.. In those people there is more probe to risk of infection.

Uncomplicated UTI is mostly seen in normal healthy women with no anatomical and functional abnormalities and there is no underlying disease but where as complicated UTI is seen in conditions where there is chances of increased colonisation such as urethral obstruction.. Bladder obstruction due to stone or prostate hypertrophy in males.. Or presence of stones in ureter..