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Urinary tract infection, UTI (mechanism of disease)

This is a mechanism of disease map for UTIs, covering the etiology, pathophysiology, and manifestations. ADDITIONAL TAGS: Infection ascends to kidneys → pyelonephritis Fever Fatigue/malaise CVA tenderness Flank pain Nausea and vomiting Congenital malformations Enterobacter species Risk factors / SDOH Cell / tissue damage Structural factors Urinary tract infection Medicine / nosocomial Infectious / microbial Biochem / molecular bio Immunology / inflammation Signs / symptoms Tests / imaging / labs Metabolic / hormonal Genetics / hereditary Flow physiology Pathophysiology Etiology Manifestations Irritation of the urethral meatus Pathogen growth in the urinary tract ↑ seeding infxn Urinary stasis Female Shorter urethra Urethra and anal/genital regions are close Male: uncircumcised infants Escherichia coli (80%) Staphylococcus saprophyticus Klebsiella pneumoniae Proteus mirabilis Pseudomonas, Enterococci, Serratia “SEEK PP” UTI bacteria: ↑ drug resistance ↑ ammonia Struvite stones Pungent urine Immunocompromised Viral UTI Adenovirus, cytomegalovirus, BK virus → hemorrhagic cystitis Benign prostatic hyperplasia Urinary bladder diverticulum Neurogenic bladder Urinary tract calculi Vesicoureteral reflux Catheter-associated urinary tract infection (CAUTI) Sexual intercourse (postcoital [honeymoon] cystitis) Pregnancy Chronic constipation Post- meno- pausal ↑ vaginal pH ↓ lactobacilli ↓ estrogen Irritation of the lower urinary tract ↑ urinary frequency Urinary urgency Dysuria Hematuria Suprapubic tenderness Elderly: CNS cytokines → delirium / acute confusion Peds: Irritable, poor feeding, new urinary incontinence Perinephric abscess Urosepsis Emphysematous pyelonephritis Infection ascends through male genital tract Urethral stricture Hypotension Tachycardia Tachypnea Scrotal pain, +/- reduced when elevated (+ Prehn sign) Epididymitis Orchitis Prostatitis Swollen, tender testicle Pain around prostate (perineal, pelvic, lower back), +/- with defecation Bladder outlet obstruction Pregnant: hypertension, preeclampsia, preterm labor incomplete bladder emptying Straining to urinate Weak stream