1) Identify suspected microbial agents
2) Conduct self-directed learning based on specific case and symptoms
3) Propose relevant tests according to suspected causative agents
4) Propose treatment to suspected causative agents
Keywords: Female, 67 years, Fever, Chills, Bladder distension, Indwelling catheter, Urinary tract infection, Urine specimen
Patient's Particulars
Name: Maisy Hong
Age: 67 years old
Sex: Female
Clinical Diagnosis
Complaints: Fever, chills, bladder distension (inability to urinate)
Diagnosis: Urinary tract infection (UTI)
Note: On indwelling catheter (a urinary catheter is a plastic tube which is inserted through a patient's urinary tract into their bladder)
Diagnostic approach to UTI in adults
1) Patient symptomatic? Yes, go to 2a. No, go to 2b.
2a) Complicating factors? Yes, go to 3a. No, go to 3b.
2b) Asymptomatic bacteriuria
3a) Complicated UTI
3b) Recurrent episode? Yes, go to 4a. No, go to 4b.
4a) Recurrent UTI
4b) Symptoms of upper tract involvement? Yes, go to 5a. No, go to 5b.
5a) Pyelonephritis
5b) Consider cystitis, urethritis or vaginitis (lower tract)
Usually, before proceeding to microbial identification tests, a urinalysis and chemical dipstick testing will be performed on the urine sample and important factors of UTI such as leucocytes, erythrocytes, pH as well as presence of certain chemicals like nitrite are things to look out for. As we've covered this in clinical chemistry, I will just talk about the medical microbiological portion. :)
Below is a table of possible causative agents, characteristics, proposed tests for agent identification and antibiotic susceptibility testing (treatment).
(Please click the pictures for enlarged images)
Tan Yi Wei Alex Tg02 0503222B
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