Diana Wiseman iHuman Case Summary

Diana Wiseman iHuman Case Summary

Case Summary

Learning objectives
Following completion of this case, you should be able to perform the following:

• Students can describe the key elements of the diagnostic (history, physical, and laboratory) evaluation of patients with irritative-voiding symptoms
• • Students can list the risk factors for urinary tract infections (UTI)
  Students should be able to list the parameters that support the need for inpatient treatment of severe and/or complicated UTI Diana Wiseman iHuman Case Summary
  • Students should be able to define the spectrum of causative bacterial organisms in uncomplicated and complicated UTIs
  • Students should be able to describe the classes of antimicrobial agents relevant to the genitourinary system

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Epidemiology
The annual incidence of pyelonephritis is approximately 0.12% for women receiving outpatient treatment and 0.03% for women requiring inpatient treatment. Young, sexually-active women are most often affected. Infants and the elderly are also at increased risk, reflecting anatomical changes and hormonal status.

The annual incidence of pyelonephritis is approximately 0.12% for women receiving outpatient treatment and 0.03% for women requiring inpatient treatment. Young, sexually-active women are most often affected. Infants and the elderly are also at increased risk, reflecting anatomical changes and hormonal status.
Hospital course
If this were an otherwise healthy young woman without diabetes, and if she had been able to tolerate oral antibiotics, she may have been discharged home for outpatient therapy after IV hydration. This clinical option is available, given that oral and IV bioavailability of fluoroquinolones are equivalent. Our patient’s dehydration and hyperglycemia warranted IV antibiotics and closer monitoring Diana Wiseman iHuman Case Summary.
Patient disposition
Ms. Wiseman was discharged on hospital day 3, following an uncomplicated one-day observation period on oral anfibiotics.
She was scheduled for outpatient follow-up in one week. She was instructed to complete the remaining course of levofloxacin 750 mg PO daily for a full seven days. Diana Wiseman iHuman Case Summary By the time of discharge, the patient had been on her usual diabetic-treatment regimen for several days, with normalized blood sugars.