Case 17: The Burning Urgency

MBBS
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A 23-year-old female college student visits her primary care physician with complaints of burning sensation during urination, frequent urges to urinate, and lower abdominal discomfort for the past two days. She denies fever or flank pain. She is sexually active and does not use any form of contraception. A urinalysis reveals positive nitrites and leukocyte esterase. What is the most likely diagnosis, and which organism is most commonly responsible? What would be the plan of treatment.

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Most likely diagnosis is UTI, likely caused by E. coli.
Treatment usually involves oral antibiotics for a few days to clear the infection.

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Urinary tract infections.

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Most like a Urinary Tract Infection (UTI), most likely acute cystitis. First line Antibiotics can be given in accordance to the local resistance patterns and then absolutely supportive care.

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Urinary tract infection caused by E.coli. Treatment by oral antibiotic.
A sexually active woman can also prevent UTI by urinating after intercourse to flush out the bacteria; rinsing or showering to wipe out the bacteria can help prevent UTI as well.

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UTI

Tx:- antibiotics (oral and topical) with supportive care

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  • She likely has acute uncomplicated cystitis, most commonly caused by Escherichia coli.
  • Treatment includes a short course of oral antibiotics like nitrofurantoin or trimethoprim-sulfamethoxazole, with increased hydration and symptom relief.
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The most likely diagnosis is a Urinary Tract Infection (UTI).
Symptoms include dysuria, urinary frequency, and lower abdominal discomfort.
E. coli is the most common causative organism.
A urinalysis showing positive nitrites and leukocyte esterase supports the diagnosis.
Antibiotics like trimethoprim-sulfamethoxazole or nitrofurantoin are typically prescribed.
A short course of antibiotics is usually effective.
Increased fluid intake can help flush out bacteria.
Phenazopyridine may provide short-term symptom relief.
Follow-up care may be necessary to ensure symptoms resolve.
Preventive measures, such as proper hygiene and hydration, can reduce future risk.

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The most likely diagnosis is urinary tract infection (UTI), commonly caused by Escherichia coli. Treatment typically includes a short course of antibiotics such as nitrofurantoin or trimethoprim-sulfamethoxazole.

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