Woman Suffering from a Stomach Pain
Woman Suffering from a Stomach Pain

So what are some of the clinical manifestations of UTI, cystitis patients will complain of irritative weighting habits that means they have burning with urination or dyseria urgency frequency to void suprapubic pain, possible hematuria when they have pyelonephritis, remember that it’s UTI that involves the kidney and upper tracts that patient is going to present with fevers, chills, flank pain and they’re going to have costovertebral ankle tenderness on physical exam that might be associated with nausea, vomiting and pain in the lower abdomen. They may not always have irritative weighting symptoms or symptoms of cystitis, there are some atypical presentations and complicated UTI that we should be aware of as well prostatitis in men typically presents with symptoms of cystitis so dysuria urgency frequency to void but oftentimes men will complain of pelvic pain as well as in the elderly, we need to worry about more generalized signs and symptoms of infection so things like fevers chills or altered mental status may be the way an elderly person will present so based on a patient’s clinical presentation we can or cannot suspect for uti.

We now are going to look for physical exam findings that can help us with diagnosis, costo vertebral angle tenderness or abdominal and suprapubic tenderness are going to be common in patients who have urinary tract infection, a digital rectal exam to evaluate for edematous prostate is going to be helpful for prostatitis in men with pelvic or perineal pain, laboratories are also going to be helpful in the diagnosis of UTI so looking at our urine analysis or our urine dipstick, the presence of leukocyte esterase indicates white blood cells that are present in the urine the presence of nitrites then tells us that gram-native bacteria such as the enterobacteracia are present as well now be careful because staph and enterococcus do not reduce nitrates to nitrite so we may be missing that just on a urinary dipstick alone.

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