Clinical features and investigations for different UTI syndromes

Clinical features and investigations for different UTI syndromes

Condition	Clinical symptoms	Routine urine analysis	Culture	Radiology
Asymptomatic bacteriuria (ASB)	Nil	May or may not have significant pyuria and/or dipstick leukocyte esterase test positive	Positive	Normal
Acute Cystitis	Fever with chills Frequency, urgency, dysuria Suprapubic tenderness	Significant pyuria and/or Dipstick leukocyte esterase test positive	Positive	Bladder wall thickening
Acute Pyelonephritis	In addition to cystitis- Vomiting, flank pain, renal angle tenderness Hypotension Features of septicemia in young infants	Significant pyuria and/or Dipstick leukocyte esterase test positive	Positive	Ultrasound –renal swelling CECT if performed -Renomegaly, decreased opacification of affected area, perinephric fat stranding underlying Congenital anomalies of the kidney and urinary tract (CAKUT) DMSA if performed - Photopenic area
Acute epididymo-orchitis	Acute onset unilateral scrotal pain with / without swelling; Torsion to be ruled out	Significant pyuria and/or dipstick leukocyte esterase test positive	-Urethral swab for N. gonorrhoeae culture -MSU for microscopy and culture First pass urine /urethral swab for nucleic acid amplification test (NAAT) for N. gonorrhoeae, C. trachomatis and M. genitalium, if available	Colour Doppler ultrasound for Testicular vascularity assessment to differentiate between epididymo-orchitis and testicular torsion.

 

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