Urinary infections

• Definition: any bacteriuria exceeding a total of 105 colonies germeni/mm3 urine
• Classification:
ØITU acute
Chronic ØITU
• urinary tract infections include:
Øpapilita (infection of the renal papilla)
ØPielita (infection of the pelvis)
ØUreterita (infection of the ureter)
ØCistita (bladder infection)
ØUretrita (infection of the urethra)
• urogenital infections parenchyma:
ØNefrita (intrarenal tract infection
and renal parenchyma)
ØPionefrita (suppurative infection of renal parenchyma)
ØProstatita (infection of the prostate parenchyma)
ØOrhita (unilateral or bilateral testicular inflammation)
ØOrhiepididimita (infection of the testicle and epididymis)
• Etiopathogeny:
ØFactori Constitution: pH females by vaginal discharge, pregnancy, menstruation
ØDeficite immune
ØCarente vitamins and protein
ØFactori kidney: inhibition of leukocyte phagocytosis and migrations, length of the urethra, micturition disorders, vesicoureteral reflux, bladder catheterization, congenital malformations
• Cystitis: is a clinical syndrome caused by inflammation of the lining of the bladder
• Etiology: is infectious (E.coli is the largest in the disease pathogen, Klebsiella, Staphylococcus)
• Clinical:
ØPolachiurie (increase in urination)
ØPiurie (opaque-cloudy urine since the micturition)
ØDisurie (pain urinate)
OPOS fever and chills
• Treatment:
General ØMasuri: fluid intake (at least 2l/zi, avoiding sex, toilet locally appropriate, avoid synthetic underwear, avoiding some irritant soaps)
ØMedicamentos: Biseptol 1 3HP (480mg) X2/zi, Ciprofloxacin (250-500mg/zi) Cephalexin (250-500mg/zi), Augmentin (2g/day)
ØInitierea the antibiotic therapy is indicated as directed especially to recurrent infections
• Urethritis: includes two categories of diseases
ØGonococice
ØNongonococice
• gonococcal urethritis is gonococcal infection with the etiologic agent
• The route of transmission is strictly sexual
• Clinic patient will present a variable incubation period (usually 3-10days)
• Symptoms include:
ØSecretie urethral
ØSensibilitate urethral
ØEdem and redness of the urethral meatus
• The diagnosis is established by identifying cocci on smear with stain
• Treatment:
OPO: ciprofloxacin 500mg single dose of doxycycline 100mgX2/zi followed for 7 days
ØParenteral: ceftriaxone 250mg im + 100mgX2/zi doxycycline for 7 days or spectinomycin 2 g im If allergy preparations as first
• Urethritis nongonococica: has a varied etiology that may include-> chlamydia, cytomegalovirus, tricohmonas, ureaplasma, simplex virus
• Clinic incubation period varies (7-21days), or the patient may be asymptomatic or may present meatal penile lesions suggestive of herpetic urethritis
• The diagnosis is established on account of examination urethral secretions
• Treatment:
ØTetraciclina 500mgX4/zi for 7-10days
ØDoxiciclina 100mgX2/zi for 7-10days
ØEritromicina 500mgX4/zi for 7-10days
• Prostatitis is a special group of infections that can develop either in the form of acute or chronic shaped
• Acute prostatitis:
• Etiology: Escherichia coli, Proteus, Pseudomonas, fecalis streptococcus, staphylococcus
• Clinical: fever, chills, micturition urgency, urinary frequency, nocturia, dysuria, perineal pain.
• Diagnosis is based on urinalysis, urine culture
• Treatment:
General ØMasuri: bed rest, adequate hydration, analgesics, anti-inflammatory, tonic prostate (vitamin E) in warm sitz baths
Specific ØMasuri: initial antibiotic therapy with Biseptol 1000mg/zi to obtain the urine culture results subsequently can adminsitrat Ampicillin + Gentamicin 5mg/kgc/zi 2g/day iv for 7 days
• Chronic prostatitis: has the same etiology as the acute but because of the possibility of minimal clinical manifestations to be ignored evolving to a chronic infection.
• Clinic: urinary frequency, nocturia, dysuria, fever, chills, urinary frequency, hematuria, hemospermie
• Treatment: erythromycin for 500mgX4/zi
7-10days, after maintenance treatment with 100mg/day Nitrofurantion a long time and trophic prostate (vit E 1cp/zi)

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