Urinary Tract Infections


What is Urinary Tract Infections?

In fact tests on large numbers of schoolchildren have indicated that many youngsters, especially girls, often harbour germs in the bladder. There are not necessarily any symptoms. –It is frequently called a silent bacteriuria. Apparently germs may lie there quiescent for some time. But if there is a sudden “chill,” or lowering of the body temperature, they multiply and make their unpleasant presence felt.

The child may experience a chill, and possibly shivering. The temperature may rise. There may be the desire to pass the urine often. This may be painful, or it may be worse as the last few drops are being voided. Often, when this has happened, the child may want to run off to the toilet again, frequently within a few minutes. Of course, only half a teaspoonful may be passed and this likewise may feel hot and burning. “Like powdered glass,” is a common way of expressing it. I’m not certain how children know what it is like to void powdered glass, but you get the idea, I’m sure.

Sometimes the urine may be foul smelling. It may be cloudy, or there may blood in it. This is not a very good sign. There may be tenderness over the bladder, or over the lower part of the back. The kidneys are just inside this part and they may be tender in the so-called “renal angle,” as the doctors say. The patient may feel generally unwell, may vomit, have loss of appetite, feel clammy and hot and may be weepy and depressed.

Urinary Tract Infections Treatment

With acute symptoms, it’s wise to have medical attention. The doctor will probably order a urine test. A “midstream” specimen is examined by the pathologist, who will check for abnormal components such as blood or albumen, which indicate that abnormal substances are being filtered by the renal mechanism.

The pathologist will also carry out a culture and sensitivity test. This means the germs responsible for the infection are grown so they may be identified. At the same time, they will be checked against the commonly used antibiotics to determine which is the most suitable one for checking the infection, and preventing a recurrence.

Often the doctor will give immediate treatment. But when the results are to hand, it may be changed. A wide variety of antibiotics is currently available. These are highly satisfactory for renal tract infections. Some doctors give a large single dose. Other doctors prefer to continue therapy for some time in an effort to eradicate all traces of infection, and hoping future ones will not take place.

Often urinary “alkalinising agents” are given. These convert the urine to an alkaline state, and this is believed to help kill off the germs. But some other antibiotics act more successfully in an acid medium. Usually a total package form of treatment is prepared for the individual patient.

Extra fluids are usually prescribed. Plenty of water-based fluids and fruit juices are a good idea. Repeat often. If the is a fever and aches and pains, paracetamol elixir often reduces both. Aspirin products are best not given for these symptoms.

Sucking bits of chipped-up ice s good if there is vomiting. Flavoured ones may be made, such as using lemonade. Often a quick, lukewarm sponge will make the youthful patient feel much better. Sometimes, if hot and miserable, a cold pack to the forehead can help improve feelings.

Infections of the urinary tract are extremely common, particularly in women and children. Prompt diagnosis and treatment are essential. If problems recur, then investigation to find the basic cause is imperative. Infections may be present without any symptoms. Progressive kidney disease may readily occur, and if this becomes well established and chronic, there is no suitable long term cure.

Infections of the Urinary Tract Symptoms suggesting infection of the urinary tract are very common. Surveys show that between 12 and 20 of every 1000 surgery consultations arc for this reason.

“Urinary tract infection is one of the most common disorders encountered by the practising clinician,” a Melbourne kidney specialist says. “At all ages, the female is more prone to develop urinary tract infection and in particular, symptoms of dysuria [difficulty in urinating] and frequency are very common in adult women, most of whom have no associated abnormality in the urinary tract.” Much research has taken place in the past few years, and more accurate ways of determining the cause have been worked out. Tests quite different from those used a few years ago are now being used widely in diagnosis and treatment.

Often urinary tract infections are present, yielding no symptoms. Also, other considerations, such as the so-called “vesico-ureteric reflux,” are being demonstrated by new X-ray methods.

This means that during voiding, in some cases the urine is moved back or refluxes into the urethras, the tubes conveying the urine from the kidneys to the bladder. The significance is that this may produce damage and scarring in the kidneys that may have long-term adverse consequences for the patient.

Symptoms.

Often there are no symptoms, or there may be increased frequency of urination and discomfort. In a typical attack, there may be a feeling of being off-colour or quite ill. There may be a high fever with shivers, vomiting, headache and aches and pains all over, and probably constipation. There may be a dull, aching pain in the loin, and possibly marked tenderness over the lower part of the back. An attack may settle, to recur a little later on. There may or may not be associated elevation of the blood pressure.

Diagnosis is usually made on clinical grounds, and this may be confirmed by having a bacterial count carried out. The colonies of infecting organisms are actually checked, and it is accepted that a colony count of 100,000 per ml of urine is evidence of infection. Counts of 10,000 or less are usually considered to be due to contamination of the urine sample during collection.

The majority of urinary infections are due to organisms that are sensitive to sulfas, and these are usually given for at least 10 days. Infections resistant to sulfas should be treated with other suitable antibiotics following special sensitivity tests. These are special tests done in the laboratory in which the germ is cultured and subjected to various antibiotics. In this way the most appropriate antibiotic may be found, and used in subsequent treatment.

Often the cephalosporins, ampicillin, co-trimoxazole or tetracyclines are suitable and effective. Other drugs are available also, such as nitrofurantoin and nalidixic acid tablets. Follow-up bacterial tests are carried out to check the efficacy of therapy.

If the infection recurs or fails to be cured with simple therapy, further investigations will be ordered, such as a kidney X-ray. This is called an intravenous pyelogram (or IVP). Alternatively a CT scan or ultrasound investigation may be carried out. The aim is to discover if there is any obvious disorder of the kidneys, or if there are any anatomical structural anomalies present that could be the basic cause of the infection. Congenital defects, if present, may be an important cause for recurring infections, particularly in children. Prolonged courses of antibiotics may be necessary, especially in children, in an effort to prevent progressive renal damage. Some infections and organisms are very difficult to eradicate.

Surgery may be recommended. If investigation indicates that anatomical or structural faults are present, surgical measures may be recommended. When infections are successfully treated, vesico-ureteric reflux may disappear, but if it persists, it may indicate the need for corrective surgery. This may be in the form of a ureteric transplant or the relief of any obstruction to the bladder neck. The patient should also be instructed in sexual hygiene, and told how to reduce the risks of fecal contamination (eg using toilet tissues with a front-to back sweep, rather than vice versa). Suggestions on avoiding infections following intercourse may be offered. Particularly in newlyweds, and those indulging often in sexual intercourse, urinating as soon as possible afterwards is advisable. Treating any urinary infection promptly is essential, and adequate follow- up is wise. Any child with fevers for no obvious reason could he suffering from urinary infections, and the doctor will check this. Efforts should be made at preventive medicine, for the outlook for recurring infections is poor. It may become chronic, and for this there is no simple cure.