Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- dysuria
- urinary frequency
- hematuria
- back/flank pain
- costovertebral angle tenderness
- fever
Outros fatores diagnósticos
- urinary urgency
- suprapubic pain and tenderness
Fatores de risco
- sexual activity
- spermicide use
- postmenopause
- positive family history of UTIs
- history of recurrent UTI
- presence of a foreign body
- insulin-treated diabetes
- high lifetime number of UTIs
- recent antibiotic use
- poor bladder emptying
- increasing age
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- urine dipstick
- urine microscopy
- urine culture and sensitivity
Investigações a serem consideradas
- postvoid residual (PVR)
- renal ultrasound
- abdominal/pelvic CT scan
- cystoscopy
Algoritmo de tratamento
confined to bladder without complicating factors
complicating factors present (nonpregnant): suitable for outpatient therapy
pregnant: suitable for outpatient therapy
complicating factors present (nonpregnant): requiring inpatient therapy
pregnant: requiring inpatient therapy
recurrent confined to bladder (3 or more in 12 months): related to sexual intercourse
recurrent confined to bladder (3 or more in 12 months): unrelated to sexual intercourse
Colaboradores
Consultores especialistas
Una J. Lee, MD
Female Pelvic Medicine and Reconstructive Surgery
Section of Urology and Renal Transplantation
Virginia Mason Medical Center
Seattle, WA
Declarações
UJL declares that she has no competing interests.
Agradecimentos
Dr Una J. Lee would like to gratefully acknowledge Dr Elliot Blau for his contribution to this topic, and Dr Bhavin N. Patel and Dr Howard B. Goldman, previous contributors to this topic.
Declarações
EB, BNP, and HBG declare that they have no competing interests.
Revisores
Bernard G. Jaar, MD, MPH
Clinical Director
Johns Hopkins School of Medicine
Division of Nephrology
Baltimore, MD
Declarações
BGJ declares that he has no competing interests.
Timothy J. Benton, MD
Associate Residency Director
Texas Tech University Health Sciences Center
Amarillo, TX
Declarações
TJB declares that he has no competing interests.
Paul Little, BA (Oxon), MBBS, MRCP, MSc, FRCGP, MD
Professor of Primary Care Research
Community Clinical Sciences Division
University of Southampton
Southampton
UK
Declarações
PL declares that he has no competing interests.
Créditos aos pareceristas
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Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Trautner BW, Cortes-Penfield NW, Gupta K, et al. IDSA 2025 guideline update on complicated urinary tract infections. Jul 2025 [internet publication].Texto completo
European Association of Urology. EAU guidelines on urological infections. Mar 2025 [internet publication].Texto completo
American College of Obstetricians and Gynecologists. Urinary tract infections in pregnant individuals. Obstet Gynecol. 2023 Aug 1;142(2):435-45.Texto completo Resumo
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
- Asymptomatic bacteriuria
- Pyelonephritis
- Urinary tract stones
Mais Diagnósticos diferenciaisDiretrizes
- EAU guidelines on urological infections
- IDSA 2025 guideline update on complicated urinary tract infections
Mais DiretrizesFolhetos informativos para os pacientes
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