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)
- anatomic/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
- complete blood count
- erythrocyte sedimentation rate
- C-reactive protein
- procalcitonin
- blood culture
Investigations to consider
- renal ultrasound
- contrast-enhanced spiral computed tomography
- magnetic resonance imaging
Treatment algorithm
Contributors
Authors
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 reviewers
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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