UTI

Fecal bacteria access urethra

Bacterial entry

Predisposing factors

Pathogenesis of UTI

Bacteria entering the urinary tract from nearby vagina and perineum

E. coli

Klebsiella

Group B streptococcus

S. Saprophyticus

Proteus

Enterococcus

Bacteria ascends ureteres

The pilli allows adhesion to renal parenchyma and the proliferation increases

Inflammation exacerbates

Virulence factors of pathogens

Immune response

Cytokines

Symptoms

Approach of UTI

Symptomatic?

NO

YES

Complicating factors?

Asymptomatic bacteuria

YES

NO

Complicated UTI

Recurrent episode?

YES

NO

Recurrent UTI

Symptoms of uppper tract involvement?

YES

NO

Consider cystitis, uretritis, vaginitis

PYELONEPHRITIS

NO

Differential diagnose

NO

Positive Gram for urine

NO

YES

Oseltamivir -(first choice)/ oral route

YES

Determine upper or lower UTI

UTI highly probable

YES

Suspectious

Positive Test strip

Bloody diarrhea