Last reviewed: 24 Sep 2020
Last updated: 08 Oct 2020

Summary

Definition

History and exam

Other diagnostic factors

  • nausea and vomiting
  • dysuria, frequency, or urgency
  • flank pain or costovertebral angle tenderness

Risk factors

  • urinary tract infection
  • diabetes mellitus
  • stress incontinence
  • foreign body in urinary tract (e.g., calculus, catheter)
  • anatomical/functional urinary abnormality
  • immunosuppressive state (e.g., HIV, transplantation, chemotherapy, corticosteroid use)
  • pregnancy
  • frequent sexual intercourse
  • mother with urinary tract infection history
  • new sex partner
  • spermicide use
  • age between 18 and 50 years
  • age >60 years

Diagnostic investigations

1st investigations to order

  • urinalysis
  • Gram stain
  • urine culture
  • full blood count
  • erythrocyte sedimentation rate
  • C-reactive protein
  • procalcitonin
  • blood culture
More 1st investigations to order

Investigations to consider

  • renal ultrasound
  • contrast-enhanced spiral computed tomography
  • magnetic resonance imaging
More investigations to consider

Treatment algorithm

Contributors

Professor of Medicine

Division of Nephrology

University of California

San Francisco

CA

Disclosures

LAF declares that she has no competing interests.

Dr Lynda A. Frassetto would like to gratefully acknowledge the assistance of Donna M. Frassetto. DMF declares that she has no competing interests.

Peer reviewersVIEW ALL

Attending Urologist

Providence Saint Joseph Medical Center

Burbank

Assistant Clinical Professor of Urology

Department of Urology

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

JL declares that he has no competing interests.

Consultant Nephrologist/Lead Clinician

Renal Unit

Glasgow Royal Infirmary

NHS Greater Glasgow and Clyde

Glasgow

UK

Disclosures

RM declares that he has no competing interests.

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