Diagnosis and management of urinary tract infections in the emergency department

Emerg Med Pract. 2014 Jul;16(7):1-23; quiz 23-4.

Abstract

Urinary tract infections are a heterogeneous group of disorders, involving infection of all or part of the urinary tract, and are defined by bacteria in the urine with clinical symptoms that may be acute or chronic. Approximately 1 million urinary tract infections are treated every year in United States emergency departments. The female-to-male ratio is 6:1. Urinary tract infections are categorized as upper versus lower tract involvement and as uncomplicated versus complicated. The emergency clinician must carefully categorize the infection and take into account patient host factors to optimally treat and disposition patients. A working knowledge of local or at least national susceptibility patterns of the most likely pathogens is essential. A variety of special populations exist that require special management, including pregnant females, patients with anatomic abnormalities, and instrumented patients.

Publication types

  • Review

MeSH terms

  • Anti-Infective Agents / therapeutic use*
  • Catheter-Related Infections / diagnosis
  • Catheter-Related Infections / drug therapy
  • Catheters, Indwelling
  • Critical Pathways
  • Diabetes Complications
  • Diagnosis, Differential
  • Diagnostic Imaging
  • Drug Resistance, Multiple, Bacterial
  • Dysuria / etiology
  • Emergency Medicine
  • Emergency Service, Hospital*
  • Female
  • Fluid Therapy
  • Humans
  • Immunocompromised Host
  • Kidney Transplantation
  • Male
  • Nausea / drug therapy
  • Nausea / etiology
  • Nephrolithiasis / complications
  • Pain / drug therapy
  • Pain / etiology
  • Patient Admission
  • Patient Discharge
  • Perineum / microbiology
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy
  • Prostatitis / diagnosis
  • Prostatitis / drug therapy
  • Prostatitis / microbiology
  • Ureter / physiology
  • Urinalysis / instrumentation
  • Urinalysis / methods
  • Urinary Bladder / physiology
  • Urinary Tract Infections / diagnosis*
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / microbiology
  • Urination / physiology

Substances

  • Anti-Infective Agents