A 21 year old woman presents to the office with a 3-day duration of discomfort w

Question

A 21 year old woman presents to the office with a 3-day duration of discomfort with urination and increase urinary frequency. She has noted that the urine has a strong oder as well. she denies fever, abdominal pain, back pain, vaginal discharge, or skin rash. she is sexually active and takes oral contraceptives pills. on examination she is comfortable appearing and afebile. She has no costovertable angle tenderness. abdominal exam is notable only for suprapubic tenderness. microscopic examination of sediment of a centrifuged urine sample revals 10-15 white blood cells per high power field and numerous bacteria.. What type of microorganism would a Gram stain of urine most likely show? what is the most common etiologic agent of this infevtion? what is the most likely reservior of this infection? whatis the most likely mechanism by which this microorganism infects the urinary tract? Treatment and prevention

Explanation / Answer

The woman is suffering from urinary tract infection (UTI). The most common bacterial agent which causes UTI in women is Escherichia Coli. E. Coli is a Gram negative rod shaped organism. The organism affects urethra and bladder causing urethritis and cystitis and the reservoir of infection is urinary bladder. E.coli is usually found in the gastrointestinal tract and due to close proximity of urethra with rectum in females, they are more prone to UTI with E.coli.

UTI can be prevented by taking plenty of water which will flush out the bacteria from urinary tract. Maintaining menstrual and personal hygiene is important. While cleaning the perineal area, wiping should be done from front to back. UTI are usually treated with three day course of trimethoprim/ sulphamethoxizole with ofloxacin or ciprofloxacin. Cranberry juice is also found to be effective in treating UTI.

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