外科男性泌尿生殖感染教材.pptVIP

Laboratory diagnosis Microscopic urinalysis Urine culture remains the definitive test Pretherapy cultures and susceptibility tests are also essential Management Antimicrobial selection TMP TMP-SMX Fluoroquinolones are highly effective and well tolerated. Duration of therapy With most antimicrobial agents, 3-day regimens appear optimal Single-dose therapy can be used. Prostatitis Types of prostatitis 1 acute and chronic bacterial prostatitis 2 non bacterial prostatitis 3 prostatodynia Examination of the prostatic expressate Examination of the semen Measurement of the immune response Segmented cultures of the lower tract in male Infection of GUT   Predisposing factors Obstructive: as stones, tumor, stricture, BPH Predisposing factors Body resistance, hypertension, diabetes, pregnancy Iatrogenic: catherterization, cystoscopy Renal parenchyma diseases: renal injury, renal failure, interstitial nephritis Anatomical: female urethra Routes of infection Ascending route Hematogenous route Lymphatic route Direct extension Pathogen Gram-negative: 85% Escherichia coli Gram-positive: Staphylococcus aureus Chlamydia Mycoplasma Diagnosis Clinical features Laboratory investigation urine bacterial culture and colony counting: 105/ml Urine collection Suprapubic aspiration Urethral catheterization Segmented voided urine specimens Midstream voided urine specimens Localization Ureteral catheterization Fairley bladder washout test Acute pyelonephrosis Clinical presentation chills,fever, flank pain, and unilateral or bilateral costovertebral angle tenderness dysuria, increased urinary frequency and urgency physical examination tenderness to deep palpation in the costovertebral angle abdominal pain, nausea, vomiting, diarrhea. Laboratory findings Urine culture Urinary sediment Blood test Blood culture Bacteriology E Coli accounts for 80% cases. Other members