Bacterial Infections of the Genitourinary Tract
Urinary tract infection is one of the commonest problems in all of medicine.
The big picture
Urinary tract infection is one of the commonest problems in all of medicine, and the urologist's job is to think one level deeper than "treat the bug": where is the infection, is the patient's tract normal or compromised, and is this simple or about to become dangerous? A bladder infection in a healthy young woman and the same organism in an obstructed, diabetic, or catheterised patient are completely different problems. The framework below keeps you from treating them the same.
The framework: know the usual organism and route, separate simple from complicated infection, localise it (cystitis vs pyelonephritis vs prostatitis), and recognise the dangerous variants (emphysematous pyelonephritis, perinephric abscess, xanthogranulomatous pyelonephritis, urosepsis).
Mechanism pathway
Tap any step to see why it happens.
Diagnostic algorithm
Each step answers one question. Tap to expand.
Board traps
E. coli = 70–80% of UTIs; most infection is ascending.
Simple vs complicated changes everything — a compromised tract (obstruction, stone, catheter, diabetes, pregnancy) needs the underlying cause addressed.
Cystitis is afebrile; fever/rigors mean pyelonephritis or prostatitis.
Emphysematous pyelonephritis ≈ 95% diabetic — a gas-forming emergency.
Don't treat asymptomatic bacteriuria — except in pregnancy (and pre-procedure).
Nitrofurantoin treats cystitis, not pyelonephritis or prostatitis (no tissue levels).
Foreign bodies and obstruction let bacteria persist — the infection won't clear until they're dealt with.