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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Our approach to categorizing UTI in adults and adolescents

Our approach to categorizing UTI in adults and adolescents
Acute simple cystitis*
  • Acute UTI that is confined to the bladder; typical symptoms include:
    • Dysuria
    • Urinary frequency
    • Urinary urgency
    • Suprapubic pain
  • There are no signs or symptoms that suggest an upper tract or systemic infection (refer to below)
Acute complicated UTI
  • Acute UTI accompanied by features that suggest extension beyond the bladder:
    • Fever (>99.9°F/37.7°C)
    • Chills, rigors, significant fatigue or malaise beyond baseline, or other features of systemic illness
    • Flank pain
    • Costovertebral angle tenderness
    • Pelvic or perineal pain in males
  • Symptoms of cystitis (as above) may or may not be present
Special populations with unique management considerations
  • Pregnant individuals
  • Renal transplant recipients
These definitions reflect how we categorize UTI, inform our approach to management, and differ somewhat from other conventions. Traditionally, acute uncomplicated UTI has referred to cystitis or pyelonephritis in nonpregnant premenopausal females without underlying urologic abnormalities, and complicated UTI has referred to cystitis or pyelonephritis in a patient with underlying urologic abnormalities or other significant comorbidities (including individuals with diabetes mellitus and males). Rather than use this convention, which manages patients according to patient population, we favor our approach to treatment based on the presumed extent of infection and severity of illness.

UTI: urinary tract infection.

* We do not consider patients with underlying urologic abnormalities (such as nephrolithiasis, strictures, stents, or urinary diversions), immunocompromising conditions (such as neutropenia or advanced HIV), or poorly controlled diabetes mellitus to have complicated UTI in the absence of symptoms concerning for upper tract or systemic infection. However, such patients can be at higher risk for more serious infection and have not traditionally been included in studies evaluating the antibiotic regimens we typically use for acute simple cystitis. Thus, we follow such patients more closely and/or have a low threshold to manage them as complicated UTI (eg, if they have subtle symptoms other than those listed above that could be suggestive of more extensive infection).

¶ This temperature threshold is not well defined and should be individualized, taking into account baseline temperature, other potential contributors to an elevated temperature, and the risk of poor outcomes should empiric antimicrobial therapy be inappropriate.
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