Diana Wiseman iHuman Case Summary
Educational Objectives Upon finishing this case, you should be capable of the following:
- Describing the essential components of the diagnostic process (history, physical examination, and laboratory assessments) for patients displaying irritative-voiding symptoms.
- Enumerating the risk factors associated with urinary tract infections (UTI).
- Listing the criteria supporting the necessity of inpatient treatment for severe and/or complicated UTI.
- Defining the spectrum of causative bacterial organisms in both uncomplicated and complicated UTIs.
- Describing the classes of antimicrobial agents relevant to the genitourinary system.
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Epidemiology
The yearly incidence of pyelonephritis is approximately 0.12% for women receiving outpatient treatment and 0.03% for those requiring inpatient care. Young, sexually-active women are frequently affected, while infants and the elderly face an increased risk due to anatomical and hormonal factors.
Hospital
Course In a scenario involving an otherwise healthy young woman without diabetes who can tolerate oral antibiotics, outpatient therapy after IV hydration might be considered. This option is viable as fluoroquinolones exhibit equivalent oral and IV bioavailability. However, our patient’s dehydration and hyperglycemia necessitated IV antibiotics and closer monitoring (Diana Wiseman iHuman Case Summary).
Patient
Disposition Ms. Wiseman was discharged on the third hospital day following an uncomplicated one-day observation period on oral antibiotics. She was scheduled for outpatient follow-up in one week, instructed to complete the remaining course of levofloxacin 750 mg PO daily for a full seven days. At the time of discharge, the patient had been on her usual diabetic treatment regimen for several days, resulting in normalized blood sugars (Diana Wiseman iHuman Case Summary).
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