Generalized Symptoms In Adult Women With Acute Uncomplicated Lower Urinary Tract Infection: An Observational Study

Anders Baerheim, MD, PhD, Asbjørn Digranes, MD, Roland Jureen, MD, Kirsti Malterud, MD, PhD

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In This Article

Results

The study included 398 women with a mean age of 44.6 years (range 18-87 years) and acute symptoms of uncomplicated lower UTI. Of these, 252 had bacteriuria. Background data are presented in Table 1 . Symptoms were grouped as voiding-related symptoms, local constant symptoms, and generalized symptoms and are presented accordingly, ranged in decreasing frequency.

Generalized symptoms were reported by a majority of the patients. Two thirds were feeling unwell, weak, and tired, while half of them were feeling restless, hot, and having cold sweat. One in 4 reported nausea. Generalized symptoms were scored equally frequently and to the same degree whether bacteriuria was present or not.

Frequency of the well known voiding-related and local constant symptoms are also given in Table 1 . Pressure in the genital area was reported by three quarters of the women, equally often as suprapubic pressure. The rather odd voiding-related symptom of having shudders in arms or legs while voiding did not occur infrequently (18%). In all, 67% of the patients reported that their dysuria was worst toward the end of the voiding, 19% had worst dysuria at the beginning of the voiding, and 14% were equally dysuric during the whole voiding.

Table 2 shows the symptoms depending on age. Generalized symptoms were equally distributed over all ages. Local constant ache in the lower part of the abdomen and pressure in the genital area was significantly more common in younger women than in elderly, while low backache was more prevalent in middle aged women.

The data were readdressed using factor analysis, run for identifying independent subgroups of symptoms ( Table 3 ). Two independent symptom patterns were generated, explaining 49% of the total variation in the material; out of sorts (generalized symptoms) and distressed bladder (voiding-related and local constant symptoms). Factor scores were computed for each pattern. Feeling out of sorts dominated among patients aged 50-65 years, while having a distressed bladder dominated in the youngest patients.

In 209 of 252 cases with bacteriuria (82%), E coli was the etiologic agent. Other bacteria isolated were Proteus spp. (7 cases), Klebsiella spp. (6 cases), and other Gram-negative rods (6 cases). Twenty-two women were infected with S saprophyticus, and 2 with enterococci. There was no difference in symptom pattern score or factor analysis symptom patterns whether the patient had bacteriuria or not ( Table 1 and Table 3 ).

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