UTI / Pyelonephritis
Genitourinary · ~4% of blueprint- Pathophysiology
- Ascending bacterial infection (usually E. coli); cystitis (bladder) vs. pyelonephritis (kidney).
- Signs & Symptoms
- Cystitis: dysuria, frequency, urgency. Pyelonephritis adds fever, flank/CVA pain, and N/V.
- Gold Standard Diagnosis
- Urinalysis (pyuria, nitrites, leukocyte esterase) + urine culture (gold standard).
- First-line Treatment
- Cystitis: nitrofurantoin, TMP-SMX, or fosfomycin (per local antibiogram). Pyelonephritis: fluoroquinolone, TMP-SMX, or ceftriaxone — 5–7 d of a fluoroquinolone or 7 d of other agents.
High-Yield Pearl
Nitrites + leukocyte esterase on UA strongly suggest UTI; culture confirms and guides therapy. Nitrofurantoin and fosfomycin don't reach the kidney — never for pyelonephritis.
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Sources
Reviewed September 2026- Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025) — American Urological Association, 2025
- 2025 IDSA Guideline on Complicated Urinary Tract Infections: Selection of Antibiotic Therapy — Infectious Diseases Society of America, 2025
- 2025 IDSA Guideline on Complicated Urinary Tract Infections: Duration of Antibiotics — Infectious Diseases Society of America, 2025
- StatPearls: Acute Pyelonephritis — StatPearls Publishing / NCBI Bookshelf, 2024
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