Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- dysuria
- urgency
- frequency
- suprapubic pain
- prior history of urinary tract infections (UTIs) and treatment history
Outros fatores diagnósticos
- recent urinary tract instrumentation
- flank pain
- abdominal pain
- fever
- vaginal discharge
- vaginal pruritus
- dyspareunia
- structurally or functionally abnormal bladder
Fatores de risco
- frequent sexual intercourse
- history of UTI
- anatomic or functional abnormalities within the urinary tract
- spermicidal jelly
- urinary catheter
- asymptomatic bacteriuria during pregnancy or prior to urological surgery
- diabetes
- spinal cord injuries
- pregnancy
- immunosuppression
- older age
- lack of circumcision
- age <15 years for first UTI
- new sex partner in past year
- UTI history in mother
- diaphragm use
- obesity
- vaginal atrophy
- low socioeconomic status
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- urinalysis
- urine microscopy
- urine culture with sensitivity
Investigações a serem consideradas
- pregnancy test
Algoritmo de tratamento
uncomplicated urinary tract infection (UTI): nonpregnant
complicated UTI: nonpregnant
uncomplicated or complicated UTI: pregnant
at risk of chronic recurrent UTI
Colaboradores
Autores
Christopher Chapple, BSc, MD, FRCS (Urol), FEBU
Honorary Senior Lecturer of Urology
University of Sheffield
Consultant Urological Surgeon
Department of Urology
Royal Hallamshire Hospital
Sheffield
UK
Declarações
CC is a consultant for MUVON Therapeutics, Proverum (on safety committee), Symimetic (non-financial), and Urovant Sciences. He is an author for Astellas and Ferring. He is a speaker for Allergan.
Altaf Mangera, MBChB (Hons), MD, FRCS (Urol), FEBU
Consultant Urologist
Department of Urology
Royal Hallamshire Hospital
Sheffield
UK
Declarações
AM declares that he has no competing interests.
Agradecimentos
Dr Christopher Chapple and Dr Altaf Mangera would like to gratefully acknowledge Dr Michael K. Park, a previous contributor to this topic.
Declarações
MKP declares that he has no competing interests.
Revisores
James Malone-Lee, MD, FRCP
Professor of Medicine
Department of Clinical Physiology
Division of Medicine
Whittington Campus
University College London Medical School
London
UK
Declarações
JML declares that he has no competing interests.
David Chelmow, MD
Chair
Department of Obstetrics and Gynecology
Virginia Commonwealth University
Richmond
VA
Declarações
DC declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
European Association of Urology. Guidelines on urological infections. 2023 [internet publication].Texto completo
American Urological Association. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline. 2022 [internet publication].Texto completo
Nicolle LE, Gupta K, Bradley SF, et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis. 2019 May 15;68(10):e83-110.Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Pyelonephritis
- Vaginitis
- Interstitial cystitis
Mais Diagnósticos diferenciaisDiretrizes
- Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)
- IDSA 2024 guidance on the treatment of antimicrobial resistant gram-negative infections
Mais DiretrizesFolhetos informativos para os pacientes
Cystitis
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