The Washington Manual of Medical Therapeutics helps you diagnose and treat hundreds of medical conditions. Consult clinical recommendations from a resource that has been trusted on the wards for 50+ years. Explore these free sample topics:
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- The spectrum of genitourinary tract infections varies from uncomplicated to complicated, depending on host factors and underlying conditions. Diagnostic and therapeutic approaches to adult genitourinary infections are determined by gender-specific anatomic differences, prior antimicrobial exposures, and the presence of catheters, stents, etc. Infections are primarily caused by Enterobacteriaceae (E. coli, Proteus mirabilis, and K. pneumoniae) and Staphylococcus saprophyticus.
- Workup typically includes urinalysis and microscopic examination of a fresh, unspun, clean-voided, or catheterized urine specimen. Pyuria (positive leukocyte esterase or ≥8 leukocytes per high-power field) or bacteriuria (positive nitrites or ≥1 organism per oil-immersion field) suggests active infection. A high number of epithelial cells indicates an inadequate sample. A urine Gram stain can be helpful in guiding initial antimicrobial choices. Quantitative culture often yields >10 bacteria colony forming units (CFU)/mL, but colony counts as low as 10–10 bacteria/mL may indicate infection in women with acute dysuria.