Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- disúria
- urgência
- polaciúria
- dor suprapúbica
- dor no ângulo costovertebral
Outros fatores diagnósticos
- hesitação
- noctúria
- próstata aumentada
- próstata com sensibilidade à palpação
- dor retal/perineal
- febre/calafrios
- secreção uretral
Fatores de risco
- hiperplasia prostática benigna
- cálculos no trato urinário
- cirurgia urológica, instrumentação
- estenoses uretrais
- idade >50
- ITU prévia
- cateterismo
- sexo anal
- sexo vaginal
- internação recente
- não circuncidado
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- urinálise de tira reagente
- microscopia da urina
- urocultura
- coloração de Gram
Investigações a serem consideradas
- tomografia computadorizada (TC) do trato renal
- ultrassonografia
- radiografia simples dos rins, ureter e bexiga (RUB)
- urograma intravenoso (UIV)
Algoritmo de tratamento
bacteriúria assintomática antes do procedimento urológico
não grave e tolerando o tratamento por via oral
grave ou não tolerando o tratamento por via oral
Colaboradores
Autores
Timothy J. Benton, MD
Regional Chairman
Residency Program Director
Associate Professor
Department of Family and Community Medicine
Texas Tech University Health Sciences Center
Permian Basin Campus
Odessa
TX
Divulgaciones
TJB declares that he has no competing interests.
Revisores por pares
Catherine DuBeau, MD
Professor of Medicine
Dartmouth Hitchcock Medical Center
Lebanon
NH
Divulgaciones
CD is a member of the American Geriatrics Society Revision Panel for the Beers criteria for potentially inappropriate medications in older persons; planning committee, speaker, and manuscript co-author for the American Urogynecological Association State of the Science on OAB and cognition; and co-investigator, RELIEF trial (botulinum toxin for refractory overactive bladder in older women, funded by PCORI.
Richard Viken, MD
Professor of Family Medicine and Chairman of the Department of Family Medicine
University of Texas Health Sciences Center
Tyler
TX
Divulgaciones
RV declares that he has no competing interests.
Robert Pickard, MD, FRCS (Urol)
Professor of Urology
Institute of Cellular Medicine
Newcastle University
Newcastle upon Tyne
UK
Divulgaciones
RP declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
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 2;68(10):e83-110.Texto completo Resumen
Kranz J, Bartoletti R, Bruyère F, et al. European Association of urology guidelines on urological infections: summary of the 2024 guidelines. Eur Urol. 2024 Jul;86(1):27-41.Texto completo Resumen
European Association of Urology. Guidelines on urological infections. Apr 2024 [internet publication].Texto completo
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Hiperplasia prostática benigna (HPB)
- Prostatite
- Pielonefrite
Más DiferencialesGuías de práctica clínica
- Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update
- Urinary tract infection (recurrent): antimicrobial prescribing
Más Guías de práctica clínicaFolletos para el paciente
Infecções do trato urinário em homens
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