The bladder infection which is termed as urinary tract infection. The bladder infection might occur anywhere in the kidney tract such as urinary tract,urethra and renal,ureters
It is more among the female and accounts for 20-30% of the cases worldwide
the structure of the kidney includes ureter,renal component which constitutes glomeruli,bowmen’s capsule,proximal convoluted tubule,distal convulted tubule,collecting duct.The main function of the kidney is to collect and filtrate the blood and blood products.
The urinary tract, from the kidneys to the urethral meatus, is normally sterile and resistant to bacterial colonization despite frequent contamination of the distal urethra with colonic bacteria. The major defense against urinary tract infection (UTI) is complete emptying of the bladder during urination. Other mechanisms that maintain the tract’s sterility include urine acidity, the vesicoureteral valve, and various immunologic and mucosal barriers.
About 95% of UTIs occur when bacteria ascend the urethra to the bladder and, in the case of pyelonephritis, ascend the ureter to the kidney. The remainder of UTIs are hematogenous. Systemic infection can result from UTI, particularly in older patients. About 6.5% of cases of hospital-acquired bacterimia are attributable to UTI.
Uncomplicated UTI is usually considered to be cystetitis or polynephritis that occurs in premenopausal adult women with no structural or functional abnormality of the urinary tract and who are not pregnant and have no significant comorbidity that could lead to more serious outcomes. Also, some experts consider UTIs to be uncomplicated even if they affect postmenopausal women or patients with well-controlled diabetes. In men, most UTIs occur in children or older patients, are due to anatomic abnormalities or instrumentation, and are considered complicated.
The rare UTIs that occur in men aged 15 to 50 years are usually in men who have unprotected anal intercourse or in those who have an uncircumcised penis, and they are generally considered uncomplicated. UTIs in men this age who do not have unprotected anal intercourse or an uncircumcised penis are very rare and, although also considered uncomplicated, warrant evaluation for urologic abnormalities.
Complicated UTI can involve either sex at any age. It is usually considered to be pyelonephritis or cystitis that does not fulfill criteria to be considered uncomplicated. A UTI is considered complicated if the patient is a child, is pregnant, or has any of the following:
Urine culture: The urine culture of the bacteria reveals the type of bacteria and the number of bacterial count.
Urinanalysis: The urine analysis includes the red blood cell count,white blood cell count.T
Ultrasound: The ultrasound which reveals the inflammation the ureter,renal,urethra. And provides the information about the renal calculi,hydronephrosis and obstruction.
Temperature: an increase in temperature increase greater than 38 degree indicates the infection
Urine dipstick:
Leukocyte esterase and nitrites if tends to be positive then go for the urinary culture.
Micturating cystography:
During cystography, contrast dye is injected into the bladder. Contrat dyes are placed in the body that causes the particular organ or tissue under study to be seen more clearly. X-rays are taken of the bladder, and fluoroscopy may be used to study the bladder emptying while a person urinates (voiding cystography). Cystography may indicate how well the bladder emties the urine and whether any urine backs correctly (vesicoureteral reflux).
DMSA scintigraphy(dimercaptosuccinic acid):
It is a radionucleoside scanning that reveals the morphology of renal morphology,structure and function.
Radioactive technetium-99m is combined with DMSA and injected into a patient, followed by imaging with a gamma camera after 2-3 hours.
CT scan:
The CT scan involves the slicing of the kidney and detecting the abnormalities.
The prgnosis is based on the antibiotic course and its effects.
1 week course of antibiotic is needed and it should be follow up