Urinary Tract Infections

UTI

Host Defence & Susceptibility

1. Flushing action of urination

2. Shedding of epithelial cells

3. Uretic peristalsis

4. Uretic valves

Increasing susceptibility;

1. Urethral length 2. Renal calculi/stones 3. Pregnancy 4. Enlarged prostate 5. Bladder function affected by Paralytic disease

Cystitis

Acute infection > inflammation > dysuria, oliguria & mild fever

Elevated WBC & urine proteins

Most commonly acquired from community acquired E. Coli infection (endogenous)

Pyelonephritis

Characterised as pus-inflammed nephrons

Presents with WBC casts in loop of henle

Symptomology; fever, rigors & back pain

Asymptomatic Bacteriuria

Colonisation of urinary tract lumen without inflammation > no symptoms

If left untreated; asymptomatic infection may become symptomatic

Example; asymptomatic bacteriuria in urinary tract > pressure from baby on tract > inhibits complete bladder emptying & causes bladder reflux

Renal Tuberculosis

Haematogenous spread from lungs

Detected by Mantoux (tuberculin) test (+ve) & EMU (early morning complete collection urine)

Schistosomiasis

Normally acquired flat worm/fluke infection from overseas travel

Chronic infection of bladder > carcinoma of the bladder due to chronic dysplasia

Bacterial Attributes

- Capsulated (E.g like Streptococcal Pneumonia)

- Haemolysin (E.g. like Streptococcal Pyogenes)

- Urease production

Childhood Infections

Measles

Highly infectious disease

Respiratory tract initially > lymphatic system > all epithelial surfaces

Symptomology; cough, runny nose & conjunctivitis occurs 9-10 days later (due to URTI presentation & delayed incubation period)

Mouth lesions may ulcerate = Koplik's spots

Complications include;

1. Secondary bacterial infection (I.e. otitis media, pneumonia & sinusitis)

2. Encephalomyelitis

3. Subacute scleorsing panencephalitis (SSPE); neurodegenerative changes occur

Rubella (German measles)

Respiratory tract infection > lymphatics system > blood stream

Symptomology; enlarged/tender nodes, coryza/conjunctivitis, fleeting rash (2-3 weeks post infection), mild polyarthritis

Congenital rubella; may occur if infected during pregnancy, if first twenty-weeks = congenital developmental defects may occur (e.g. blindness, deafness, heart & brain defects)

Roseola Infantum (Sixth disease)

Mixture of viruses > red rashed (exanthema) > temperature & "halo" rash

Parvovirus

Commonly called 'Fifth disease' or 'Slapped-cheeck' syndrome

Transmitted via respiratory route > leading to mild fever & malaise

Mumps

Types include; 1. Epididymoorchitis (may lead to sterility) 2. Aseptic meningitis (may lead to severe encephalitis) 3. Deafness 4. Mumps in pregnancy (foetal death/abortion during first trimester

Papillomavirus

Description

Reyes Syndrome

Description

Coxsackie Virus

Enterovirus family

Infection following viral myocarditis

Distinctive diseases; 1. Herpangina ("red-ringed" blisters) 2. Hand-foot-and-mouth disease (red blisters) 3. Haemorrhagic conjunctivitis