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Harrison's Principles of Internal Medicine, 18e
| Part 13. Disorders of the Kidney and Urinary Tract > |
Chapter 288. Urinary Tract Infections, Pyelonephritis, and Prostatitis
Sections: Urinary Tract Infections, Pyelonephritis, and Prostatitis: Introduction, Further Readings.
Topics Discussed: urinary tract infections and prostatitis; urologic disorders.
Excerpt:"Urinary tract infection (UTI) is a common and painful human illness that, fortunately, is rapidly responsive to modern antibiotic therapy. In the preantibiotic era, UTI caused significant morbidity. Hippocrates, writing about a disease that appears to have been acute cystitis, said that the illness could last for a year before either resolving or worsening to involve the kidneys. When chemotherapeutic agents used to treat UTI were introduced in the early twentieth century, they were relatively ineffective, and persistence of infection after 3 weeks of therapy was common. Nitrofurantoin, which became available in the 1950s, was the first tolerable and effective agent for the treatment of UTI.UTI may be asymptomatic (subclinical infection) or symptomatic (disease). Thus, the term UTI encompasses a variety of clinical entities, including asymptomatic bacteriuria (ABU), cystitis, prostatitis, and pyelonephritis. The distinction between symptomatic UTI and ABU has major clinical implications. Both UTI and ABU connote the presence of bacteria in the urinary tract, usually accompanied by white blood cells and inflammatory cytokines in the urine. However, ABU occurs in the absence of symptoms attributable to the bacteria in the urinary tract and does not usually..."
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