scholarly journals Optimizing the diagnostic work-up of acute uncomplicated urinary tract infections

2008 ◽  
Vol 9 (1) ◽  
Author(s):  
Bart J Knottnerus ◽  
Patrick JE Bindels ◽  
Suzanne E Geerlings ◽  
Eric P Moll van Charante ◽  
Gerben ter Riet
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Diagnostic Work ◽  
Tract Infections ◽  
Work Up ◽  
Diagnostic Work Up

scholarly journals Workload, diagnostic work-up and treatment of urinary tract infections in adults during out-of-hours primary care: a retrospective cohort study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Michelle Spek ◽  
Jochen W. L. Cals ◽  
Guy J. Oudhuis ◽  
Paul H. M. Savelkoul ◽  
Eefje G. P. M. de Bont
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Electronic Patient Records ◽  
Out Of Hours ◽  
Diagnostic Work ◽  
Tract Infections ◽  
Work Up ◽  
Diagnostic Work Up

Abstract Background Urinary tract infections (UTIs) are one of the most common infections in primary care. Previous research showed that GPs find it challenging to diagnose UTIs and frequently divert from guidelines leading to unwarranted antibiotic prescriptions and inefficient use of diagnostics such as urinary cultures. We hypothesise that management of UTIs during out-of-hours care may be extra challenging due to a higher workload and logistical issues regarding diagnostic work-up and obtaining results. We therefore aimed to study the workload, diagnostic work-up and treatment of UTIs during out-of-hours primary care. Methods We performed a retrospective observational cohort study in which we analysed a full year (2018) of electronic patient records of two large Dutch GP out-of-hours centres. All adult patients with UTI symptoms were included in this study. Descriptive statistics and multivariate regression were used to analyse diagnostics and subsequent management. Results A total of 5657 patients were included (78.9% female, mean age of 54 years), with an average of eight patients per day that contact a GP out-of-hours centre because of UTI symptoms. Urinary dipsticks were used in 87.5% of all patients visiting the out-of-hours centres with UTI symptoms. Strikingly, urinary cultures were only requested in 10.3% of patients in which urinary culture was indicated. Seventy-four percent of the patients received antibiotics. Seventy-nine percent of the patients with a negative nitrite test still received antibiotics. Remarkably, patients at risk of complications because of a UTI, such as men, received fewer antibiotic prescriptions. Conclusions In total, 74% of the patients received antibiotics. 8 out of 10 patients still received an antibiotic prescription in case of a negative nitrite test, and 9 out of 10 patients with an indication did not receive a urine culture. In conclusion, we found that correctly diagnosing UTIs and prescribing antibiotics for UTIs is a challenge that needs major improvement, especially during out-of-hours GP care.

Upper Urinary Tract Anomalies in Congenital Adrenal Hyperplasia

PEDIATRICS ◽  
1977 ◽  
Vol 59 (4) ◽  
pp. 639-639
Author(s):  
Rebecca T. Kirkland ◽  
Bruce S. Keenan ◽  
George W. Clayton
Keyword(s):  
Urinary Tract ◽  
Congenital Adrenal Hyperplasia ◽  
Upper Urinary Tract ◽  
Adrenal Hyperplasia ◽  
Diagnostic Work ◽  
Tract Infections ◽  
Work Up ◽  
Recurrent Hematuria ◽  
Diagnostic Work Up ◽  
Urinary Tract Anomalies

We previously reported a 7.5% incidence of congenital anomalies in 105 cases of congenital adrenal hyperplasia (CAH).1 Subsequently, we have examined the intravenous pyelograms (IVPs) of 23 patients for the presence of anomalies of the upper urinary tract. These pyelograms were performed for the following reasons: evaluation of recurrent urinary tract infections in eight patients, recurrent hematuria in one, evaluation of hypertension in one, evaluation of possible nephrosis in one, and initial diagnostic work-up in 12 patients.

Letter To The Editor

PEDIATRICS ◽  
1970 ◽  
Vol 46 (3) ◽  
pp. 481-481
Author(s):  
Solbritt Murphy ◽  
Warren Chapman
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urethral Strictures ◽  
Letter To The Editor ◽  
Tract Infections ◽  
Work Up ◽  
True Measure

Needling hurts less when it is amusing. Drs. Murphy and Chapman comment on Dr. Fink's letter as follows: Is the true measure of success the realization that someone really reads what you write? If so, we must have made it, judging by the thoroughness of Dr. Fink's critique. Not to find sex in an article one reads so carefully is certainly disappointing. There were 6 girls and 21 boys in the enuretic group. Among the girls, two had urethral strictures, grade 1 and 2 respectively, one a meatal stricture, grade 1, one had chronic urinary tract infections, one had a horse shoe kidney, and one had an incomplete work-up.

scholarly journals Painful Bladder Syndrome: An Unusual Presentation in a Case of Upper Tract Fungus Balls

2015 ◽  
Vol 9 (2) ◽  
pp. 104-105
Author(s):  
Petar Bajic ◽  
Jessica Wetterlin ◽  
Larissa Bresler
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Painful Bladder Syndrome ◽  
First Case ◽  
Painful Bladder ◽  
History Of ◽  
Tract Infections ◽  
Work Up ◽  
Fungus Balls ◽  
Collecting System

Urinary tract fungus balls are a rare pathologic entity which may be asymptomatic or have variable presentations. To date, there have been no documented cases of fungus balls presenting as painful bladder syndrome. Painful bladder syndrome is a constellation of symptoms which may include pelvic pain, urgency and frequency not explained by other causes. Here, we present the first case of these two entities concurrently. Our patient had a longstanding history of diabetes, nephrolithiasis and recurrent urinary tract infections. He presented with symptoms of painful bladder syndrome and work-up revealed filling defects within the renal collecting system concerning for malignancy. Subsequent ureteroscopy revealed dense white debris consistent with candida fungus balls. Following clearance of the debris and antifungal therapy, our patient has remained asymptomatic.

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