asymptomatic bacteriuria
TRANSCRIPT
Defination
When a bacterial count of same species over
10^5 per ml in mild stream clean catch
specimen of urine on two occasion is
detected without the symptom of urinary
infection it is called asymptomatic
bacteriuria
Causes
Asymptomatic bacteriuria occurs in a small number of healthy individuals. It more often affects women than men. The reasons for the lack of symptoms are not well understood.
Most patients with asymptomatic bacteriuriado not need treatment because the bacteria are not causing any harm. Persons who have urinary catheters often will have bacteriuria, but most will not have symptoms.
The following increases your risk:
Diabetes
Infected kidney stones
Kidney transplant
Older age
Pregnancy -- up to 40% of pregnant women with untreated asymptomatic bacteriuria will develop a kidney infection
Vesicoureteral reflux in young children
Symptoms
By definition, asymptomatic bacteriuria
causes no symptoms. The symptoms of a
urinary tract infection include burning
during urination, an increased urgency to
urinate, and increased frequency of
urination.
Exams and Tests
Asymptomatic bacteriuria is detected by the
discovery of significant bacterial growth in
a urine culture taken from a urine sample.
Treatment
Pregnant women, kidney transplant recipients, children with vesicoureteralreflux, and those with infected kidney stones are more likely to be given antibiotics.
Giving antibiotics to persons who have long-term urinary catheters in place may cause additional problems. The bacteria may be more difficult to treat and the patients may develop a yeast infection.
If asymptomatic bacteriuria is found before
a urinary tract procedure, it should be
treated to prevent complications. The course
of treatment in these cases depends on the
person's risk factors.
Possible Complications
Untreated, asymptomatic bacteriuria can
lead to a kidney infection in high-risk
individuals
When to Contact a Medical
Professional
Call your health care provider if the
following symptoms occur:
Difficulty emptying your bladder
Fever
Flank or back pain
Pain with urination
PROTEINURIA
INPREGNANCY
When 2+protein in deepstick test it is
called proteinuria
CAUSES
Pre-eclampsia and eclampsia
Urinary tract infection
Chronic Renal disease :Nephritis and
Nephrotic Syndrome
Essential hypertension
Orthostatic- Due to increased lumbar
lordosis there is increased pressure on the
inferior Venacava by the uterus or left renal
vein
Is compressed by the aorta this leads to congestion of one or both kidney leading to proteinuria.
In late pregnancy,the enlarged gravid utrerus may compress es the left renal vein when the patient is lying on supine position .lying down on lateral position relieves the pressure and congestion and makes the urine free of protein
Investigations (microscopic examination of
Pus cells RBCs Cast cells)
Management depends upon etiology
Hematuria in Pregnancy
Painful - infection
Painless – neoplastic, hyperplastic, vascular
Gross – urine appears ―RED‖; lower tract
prob.
Microscopic – > 5 RBC’s/hpf; kidney dz
False hematuria = urine appears bloody, but
dipstick results are neg. for blood and no
RBC’s on micro
Free hgb, myoglobin, porphyrins
1.Physological—menstruation
2. Infection—Pyelonephriitis , cystitis , urethritis , Tuberculosis of kidney and bladder
3. Trauma– Renal injury, Foreign body in bladder and urethra including catheter.
4.Inflammatory / autoimmune—Glomerulonephritis , Polyarteritis nodosa , Ch. Interstitial nephritis, radiatinalinflammation of renal tract.
10.Heparine therapy for DVT
11.Eclampsia
12. HellP syndrome
13. Mismatched blood transfusion
14.Pregnancy associated with hematological diseases
15.Drug induced
16. Instrumental delivery
17.Traumatic VVF
5.Stones– renal , ureteric , bladder and
urethra.
6 .Tumors– benign /malignant of renal tract.
7.General—drugs including anticoagulants
Bleeding disorders , caruncle and prolapse
of urethral mucosa.
Diagnosis:
H & P
Clean catch midstream urine for U/A
Cath urine if woman has vag. d/c, menstrual or vag. Bleeding (cath urine will rarely exceed 3 RBC’s/hpf)
Can screen with dipstick but false negs/pos may result
Abnormal RBC morphologic characteristics, RBC casts & proteinuria suggest glomerular source
If normal RBC’s then infection probable
Imaging (IVP, CT, renal US)
When haematuria(micro / Macro ) is noted
Nephrologist’s consultation should be
shout.
Clinical Assessment
Check the catheter, clinical examination of
renal tract , genital tract any other bleeding
sites
Investigations:
Complete urine examination, CBC, platelet
count , bleeding – clotting factor
profile, liver enzyme study should be
immediately ordered.