Investigation of suspected urinary tract infection in older people
Learning pointsDo not use urine dipstick tests to diagnose urinary tract infectipatagonia better sweater reviewson in older people; if they are performed at all, only a negative result should be considered useful ipatagonia trail shoes reviewn excluding a urinary tract infectionIn patients who are able to provide a history, urinary tract infection should be diagnosed only in the presence of a combination of at least three acute urinary symptoms or signs, such as dysuria, urgency, frequency, or suprapubbuy patagonia jacketsic tendernessIn patients who are patagonia jacket onlineunable to pbuy patagonia jackets1rovide a history, urinary tract infection should be diagnpatagonia simple guide pants men'sosed only when evidence exists of acute inflammation (for example, fever/hypothermia or raised white cell count or C reactive protein) associated with bacteriuria on urine culture and no other more likely cause of their acute ilbuy patagonia jackets0lness existsAsymptomatic bacteriuria is common in older people; avoid treating bacteriuria in patients with non specific symptoms that cannot be attributed to urinary tract infection, as this confers no benefit and may cause harmAn 84 year old woman, who lived in a residential home, was referred to the acute medical assessment unit with a two day history of increasing confusion of unclear cause. She was unable to provide a clear history, but her daughter mentpatagonia discount code ticketioned that she was not usually confused. On examination, her temperature was 36.8C, her heart ratpatagonia everlong review electronicse was 67 beats per minutebuy patagonia jackets2, and her blood pressure was 135/7patagonia everlong review portable dvd0 mm Hg. She looked dehydrated and was noted to be incontinent of dark, offensive smelling urine. Urinary tract infection was suspected.What is the next investigation?Suspected urinary tract infection is a common scenario when evaluating ill older adults. The diagnosis may be challenging, as patients are often unable to provide a histopatagonia guide pants in bootsry of acute urinary symptoms (for example, patagonia guide pants under $15owing to delirium or dementia), and asymptomatic bacteriuria (sebuy patagonia jackets3e table 1 for definitions) is common in older people. The prevalence of