list clinical manifestations and physical exam findings of UTI and appendicitis
list clinical manifestations and physical exam findings of UTI and appendicitis
Urinary Tract Infection (UTI) is classified into cystitis (infection of the bladder) and pyelonephritis (upper urinary tract infection). The clinical manifestations of UTI include dysuria (painful urination), urinary urgency and frequency, lower abdominal discomfort, a sensation of bladder fullness, and suprapubic tenderness (Bono & Reygaert, 2021). Flank pain and tenderness on the costovertebral angle may occur in cystitis but usually suggest an upper UTI. Other symptoms include bloody urine, fevers, chills, and malaise. Nocturia, with suprapubic pain and, at times, low back pain, is common in cystitis. Symptoms of pyelonephritis typically include fever, chills, nausea, vomiting, flank pain, and colicky abdominal pain (Bono & Reygaert, 2021. Physical findings in UTI include low-grade fever, suprapubic tenderness, and costovertebral angle tenderness in percussion, which occurs mostly in acute pyelonephritis.
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Appendicitis is characterized by acute inflammation of the vermiform appendix, which occurs when the appendix lumen is obstructed, resulting in infection when bacteria invade the appendix wall. Clinical manifestations include abdominal pain in the right lower quadrant (RLQ) that is followed by nausea, vomiting, and anorexia (Krzyzak & Mulrooney, 2020). Patients also report cramp-like pain in the epigastric or periumbilical area. The abdominal pain usually begins as periumbilical or epigastric pain, then migrates to the RLQ. Patients often lie down, flex their hips, and draw their knees up to decrease movements and avoid aggravating the pain. Physical exam findings in appendicitis include rebound tenderness, pain/ tenderness on percussion, rigidity, and guarding, which are the most specific findings (Krzyzak & Mulrooney, 2020). RLQ tenderness occurs in most patients but is non-specific. Male children occasionally have an inflamed hemiscrotum.
References
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Bono, M. J., & Reygaert, W. C. (2021). Urinary Tract Infection. In StatPearls. StatPearls Publishing.
Krzyzak, M., & Mulrooney, S. M. (2020). Acute Appendicitis Review: Background, Epidemiology, Diagnosis, and Treatment. Cureus, 12(6), e8562. https://doi.org/10.7759/cureus.8562
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