High risk and low prevalence diseases: Infected urolithiasis.
Am J Emerg Med
; 75: 137-142, 2024 01.
Article
em En
| MEDLINE
| ID: mdl-37950981
ABSTRACT
INTRODUCTION:
Infected urolithiasis is a serious condition that carries with it a high rate of morbidity and mortality.OBJECTIVE:
This review highlights the pearls and pitfalls of infected urolithiasis, including presentation, diagnosis, and management in the emergency department based on current evidence.DISCUSSION:
Although urolithiasis is common and the vast majority can be treated conservatively, the presence of a concomitant urinary tract infection significantly increases the risk of morbidity, to include sepsis and mortality. Identification of infected urolithiasis can be challenging as patients may have symptoms similar to uncomplicated urolithiasis and/or pyelonephritis. However, clinicians should consider infected urolithiasis in toxic-appearing patients with fever, chills, dysuria, and costovertebral angle tenderness, especially in those with a history of recurrent urinary tract infections. Positive urine leukocyte esterase, nitrites, and pyuria in conjunction with an elevated white blood cell count may be helpful to identify infected urolithiasis. Patients should be resuscitated with fluids and broad-spectrum antibiotics. Additionally, computed tomography and early urology consultation are recommended to facilitate definitive care.CONCLUSIONS:
An understanding of infected urolithiasis can assist emergency clinicians in diagnosing and managing this potentially deadly disease.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Pielonefrite
/
Piúria
/
Infecções Urinárias
/
Urolitíase
Limite:
Humans
Idioma:
En
Revista:
Am J Emerg Med
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos