Urinary tract infection, UTI (mechanism of disease)

This is a mechanism of disease map for UTIs, covering the etiology, pathophysiology, and manifestations.

ADDITIONAL TAGS:
Infection ascends to kidneys → pyelonephritis
Fever
Fatigue/malaise
CVA tenderness
Flank pain
Nausea and vomiting
Congenital malformations
Enterobacter species
Risk factors / SDOH
Cell / tissue damage
Structural factors
Urinary tract infection
Medicine / nosocomial
Infectious / microbial
Biochem / molecular bio
Immunology / inflammation
Signs / symptoms
Tests / imaging / labs
Metabolic / hormonal
Genetics / hereditary
Flow physiology
Pathophysiology
Etiology
Manifestations
Irritation of the urethral meatus
Pathogen growth
in the urinary tract
↑ seeding infxn
Urinary stasis
Female
Shorter urethra
Urethra and anal/genital regions are close
Male: uncircumcised infants
Escherichia coli (80%)
Staphylococcus saprophyticus
Klebsiella pneumoniae
Proteus mirabilis
Pseudomonas, Enterococci, Serratia
“SEEK PP” UTI bacteria:
↑ drug resistance
↑ ammonia
Struvite stones
Pungent urine
Immunocompromised
Viral UTI
Adenovirus, cytomegalovirus, BK virus → hemorrhagic cystitis
Benign prostatic hyperplasia
Urinary bladder diverticulum
Neurogenic bladder
Urinary tract calculi
Vesicoureteral reflux
Catheter-associated urinary tract infection (CAUTI)
Sexual intercourse (postcoital [honeymoon] cystitis)
Pregnancy
Chronic constipation
Post- meno- pausal
↑ vaginal pH
↓ lactobacilli
↓ estrogen
Irritation of the lower urinary tract
↑ urinary frequency
Urinary urgency
Dysuria
Hematuria
Suprapubic tenderness
Elderly: CNS cytokines → delirium / acute confusion
Peds: Irritable, poor feeding, new urinary incontinence
Perinephric abscess
Urosepsis
Emphysematous pyelonephritis
Infection ascends through male genital tract
Urethral stricture
Hypotension
Tachycardia
Tachypnea
Scrotal pain, +/- reduced when elevated (+ Prehn sign)
Epididymitis
Orchitis
Prostatitis
Swollen, tender testicle
Pain around prostate (perineal, pelvic, lower back), +/- with defecation
Bladder outlet obstruction
Pregnant: hypertension, preeclampsia, preterm labor
incomplete bladder emptying
Straining to urinate
Weak stream