DISEASE INFECTIOUS AGENTS SYMPTOMS DIAGNOSIS TREATMENT
Dysuria Nitrofurantoin (100mg, 2 x 5 days)
E. coli
Pollakiuria Based on symptoms Fosfomycin (Monurol, 3g)
Uncomplicated cys??s K. pneumoniae
Urinary emergency No laboratory tests Bactrim
Proteus mirabilis
Suprapubic pain Oral b-lactam (2nd level)
Dysuria
Based on symptoms
Pollakiuria
E. coli Laboratory tests (urinalysis
Urinary emergency Oral ciprofloxacin (500mg 2 x 7
Pyelonephri?s K. pneumoniae and urine culture)
Flank pain days)
Proteus mirabilis Imaging (CT scan, if
Systemic symptoms
complicated)
(nausea, vomiIng, fever)
Fever (38°C) Indwelling catheter in place
Suprapubic tenderness for more than 2 days
E. coli
Costovertebral angle pain Urine culture with no more
Catheter-associated UTI Klebsiella spp.
or tenderness than 2 organisms, 1 with Based on the urine culture
(CAUTI) P. aeruginosa
Dysuria more than 105CFU/mL
Enterococcus spp.
Pollakiuria Presence of at least one
Urinary emergency symptom
E. coli
Dysuria
Klebsiella pneumoniae Presence of symptoms Based on the urine culture
Pollakiuria
Acute bacterial prosta??s P. aeruginosa Rectal examinaIon (digital Ciprofloxacin
Urinary emergency
(ABP) Enterococcus spp. prostate palpaIon) Trimethoprim-sulphametoxazole
Voiding symptoms
Chlamydia trachoma9s Imaging (prostate abscess) (Bactrim)
Systemic symptoms
Neisseria gonorrhoea
Change catheter and repat culture
Urine culture twice Check for colonisaIon or
Dysuria
Imaging (for persistent contaminaIon
Candiduria Candida albicans Pollakiuria
candiduria with AnImycoIcs only for paIents
Urinary emergency
obstrucIon) undergoing urological procedures
and neutropenic paIents
, DISEASE INFECTIOUS AGENTS RISK FACTORS SYMPTOMS DIAGNOSIS TREATMENT
Liver cirrhosis US/CT Based on CLIF-SOFA
Monomicrobial Fever
Primary peritoni?s Ascites DiagnosIc Cephalosporin
E. coli Altered mental status
(spontaneous Haematogenous paracentesis Carbapenems with CLIF-
K. Pneumoniae Abdominal tenderness
bacterial peritoni?s, spread of AsciIc fluid analysis SOFA>7
S. pneumoniae Diarrhoea
SBP) pneumococcus in (albumin, protein, Albumin infusion in case of
Enterobacteriaceae ParalyIc ileus
children glucose, culture) complicaIons
Prior GI infecIons US/CT with peritoneal
Based on CLIF-SOFA
Polymicrobial AppendiciIs Fever thickening
Piperacillin-tazobactam,
E. coli CholecysIIs Altered mentals status Runyon’s criteria (total
Secondary peritoni?s meropenem, ertapenem,
K. Pneumoniae Mesenteric ischemia Abdominal tenderness protein > 1g/dL,
Igecycline
Enterobacteriaceae AnastomoIc Diarrhoea glucose <50mg/dL,
Surgical intervenIon
dehiscence LDH above UL)
Outpa?ent
Oral ciprofloxacin (500mg 2 x
day) + metronidazole (500mg
3 x day), or AugmenIn
E. coli Fever (even absent) (875mg 2 x day)
US/CT
Diver?culi?s K. Pneumoniae Localised tenderness Inpa?ent
Based on symptoms
Enterobacteriaceae and pain (LLQ) Bowel rest and pain control
IV anIbioIc
(ce`riaxone+metronidazole,
beta-lactam/beta-lactamase
inhibitor, meropenem)
Uncomplicated appendici?s
Non-operaIve treatment:
ce`riaxone+metronidazole or
Fever
E. coli ertapenem (7-10 days),
Right lower quadrant US/CT
Appendici?s K. Pneumoniae follow-up
tenderness and pain Based on symptoms
Enterobacteriaceae OperaIve treatment:
McBurney’s posiIve
appendectomy
Complicated appendici?s
Surgery + anIbioIc therapy
, Cholelithiasis
Percutaneous
RUO US/MRCP cholecystostomy drainage or
Lab findings (AST, ALT, surgery
E. coli
Fever bilirubin) Cholecys??s
K. pneumoniae
RUO pain and Charchoe’s triad Cholecystostomy + IV
Enterobacteriaceae
tenderness (fever, RUO pain, anIbioIc
Biliary tree diseases Enterococcus spp.
PosiIve Murphy’s sign jaundice) Choledocholithiasis
Streptococcus spp.
Gallstone Reynold’s pentad ERCP
Clostridium spp.
Jaundice (fever, RUO pain, Cholangi?s
Bacteroides fragilis
jaundice, hypotension, ERCP + IV anIbioIc
altered mental status) AnIbioIc
Piperacillin+tazobactam,
meropenem (4-7days)
Diabetes insipidus Percutaneous drainage or
Fever US/CT scan-guided
HepaIc diseases ERCP
Klebsiella RUO pain and drainage
Liver abscess PancreaIc disease Piperacillin + tazobactam x 4-
pneumoniae tenderness Lab findings
Liver transplant 6 weeks; a`er 5-7 days move
Hepatomegaly Based on symptoms
Asian ethnicity from IV to oral
Streptococcus spp. Fever
Splenectomy
Staphylococcus spp. Bacteraemia Le` upper quadrant US/CT
Splenic abscess Percutaneous aspiraIon
Fungi EndocardiIs pain and tenderness Based on symptoms
(parIal resoluIon)
Parasites Splenomegaly
Inters??al oedematous
pancrea??s
Fever Elevated lipase 3-Imes SupporIve therapy
E. coli
Biliary colic Epigastric and le` higher UL (>750U/L) Necro?sing pancrea??s
K. pneumoniae
Alcoholism upper quadrant pain Clinical history and Piperacillin-tazobactam,
Acute pancrea??s Enterobacteriaceae
Hypercalcaemia Nausea/vomiIng examinaIon based on carbapenem, cefepime-
Enterococcus spp.
MedicaIons Cullen’s and Grey- symptoms metronidazole (a`er 1st
Streptococcus spp.
Turner’s signs CT/MRI/US week)
AspiraIon, surgery,
supporIve therapy
Dysuria Nitrofurantoin (100mg, 2 x 5 days)
E. coli
Pollakiuria Based on symptoms Fosfomycin (Monurol, 3g)
Uncomplicated cys??s K. pneumoniae
Urinary emergency No laboratory tests Bactrim
Proteus mirabilis
Suprapubic pain Oral b-lactam (2nd level)
Dysuria
Based on symptoms
Pollakiuria
E. coli Laboratory tests (urinalysis
Urinary emergency Oral ciprofloxacin (500mg 2 x 7
Pyelonephri?s K. pneumoniae and urine culture)
Flank pain days)
Proteus mirabilis Imaging (CT scan, if
Systemic symptoms
complicated)
(nausea, vomiIng, fever)
Fever (38°C) Indwelling catheter in place
Suprapubic tenderness for more than 2 days
E. coli
Costovertebral angle pain Urine culture with no more
Catheter-associated UTI Klebsiella spp.
or tenderness than 2 organisms, 1 with Based on the urine culture
(CAUTI) P. aeruginosa
Dysuria more than 105CFU/mL
Enterococcus spp.
Pollakiuria Presence of at least one
Urinary emergency symptom
E. coli
Dysuria
Klebsiella pneumoniae Presence of symptoms Based on the urine culture
Pollakiuria
Acute bacterial prosta??s P. aeruginosa Rectal examinaIon (digital Ciprofloxacin
Urinary emergency
(ABP) Enterococcus spp. prostate palpaIon) Trimethoprim-sulphametoxazole
Voiding symptoms
Chlamydia trachoma9s Imaging (prostate abscess) (Bactrim)
Systemic symptoms
Neisseria gonorrhoea
Change catheter and repat culture
Urine culture twice Check for colonisaIon or
Dysuria
Imaging (for persistent contaminaIon
Candiduria Candida albicans Pollakiuria
candiduria with AnImycoIcs only for paIents
Urinary emergency
obstrucIon) undergoing urological procedures
and neutropenic paIents
, DISEASE INFECTIOUS AGENTS RISK FACTORS SYMPTOMS DIAGNOSIS TREATMENT
Liver cirrhosis US/CT Based on CLIF-SOFA
Monomicrobial Fever
Primary peritoni?s Ascites DiagnosIc Cephalosporin
E. coli Altered mental status
(spontaneous Haematogenous paracentesis Carbapenems with CLIF-
K. Pneumoniae Abdominal tenderness
bacterial peritoni?s, spread of AsciIc fluid analysis SOFA>7
S. pneumoniae Diarrhoea
SBP) pneumococcus in (albumin, protein, Albumin infusion in case of
Enterobacteriaceae ParalyIc ileus
children glucose, culture) complicaIons
Prior GI infecIons US/CT with peritoneal
Based on CLIF-SOFA
Polymicrobial AppendiciIs Fever thickening
Piperacillin-tazobactam,
E. coli CholecysIIs Altered mentals status Runyon’s criteria (total
Secondary peritoni?s meropenem, ertapenem,
K. Pneumoniae Mesenteric ischemia Abdominal tenderness protein > 1g/dL,
Igecycline
Enterobacteriaceae AnastomoIc Diarrhoea glucose <50mg/dL,
Surgical intervenIon
dehiscence LDH above UL)
Outpa?ent
Oral ciprofloxacin (500mg 2 x
day) + metronidazole (500mg
3 x day), or AugmenIn
E. coli Fever (even absent) (875mg 2 x day)
US/CT
Diver?culi?s K. Pneumoniae Localised tenderness Inpa?ent
Based on symptoms
Enterobacteriaceae and pain (LLQ) Bowel rest and pain control
IV anIbioIc
(ce`riaxone+metronidazole,
beta-lactam/beta-lactamase
inhibitor, meropenem)
Uncomplicated appendici?s
Non-operaIve treatment:
ce`riaxone+metronidazole or
Fever
E. coli ertapenem (7-10 days),
Right lower quadrant US/CT
Appendici?s K. Pneumoniae follow-up
tenderness and pain Based on symptoms
Enterobacteriaceae OperaIve treatment:
McBurney’s posiIve
appendectomy
Complicated appendici?s
Surgery + anIbioIc therapy
, Cholelithiasis
Percutaneous
RUO US/MRCP cholecystostomy drainage or
Lab findings (AST, ALT, surgery
E. coli
Fever bilirubin) Cholecys??s
K. pneumoniae
RUO pain and Charchoe’s triad Cholecystostomy + IV
Enterobacteriaceae
tenderness (fever, RUO pain, anIbioIc
Biliary tree diseases Enterococcus spp.
PosiIve Murphy’s sign jaundice) Choledocholithiasis
Streptococcus spp.
Gallstone Reynold’s pentad ERCP
Clostridium spp.
Jaundice (fever, RUO pain, Cholangi?s
Bacteroides fragilis
jaundice, hypotension, ERCP + IV anIbioIc
altered mental status) AnIbioIc
Piperacillin+tazobactam,
meropenem (4-7days)
Diabetes insipidus Percutaneous drainage or
Fever US/CT scan-guided
HepaIc diseases ERCP
Klebsiella RUO pain and drainage
Liver abscess PancreaIc disease Piperacillin + tazobactam x 4-
pneumoniae tenderness Lab findings
Liver transplant 6 weeks; a`er 5-7 days move
Hepatomegaly Based on symptoms
Asian ethnicity from IV to oral
Streptococcus spp. Fever
Splenectomy
Staphylococcus spp. Bacteraemia Le` upper quadrant US/CT
Splenic abscess Percutaneous aspiraIon
Fungi EndocardiIs pain and tenderness Based on symptoms
(parIal resoluIon)
Parasites Splenomegaly
Inters??al oedematous
pancrea??s
Fever Elevated lipase 3-Imes SupporIve therapy
E. coli
Biliary colic Epigastric and le` higher UL (>750U/L) Necro?sing pancrea??s
K. pneumoniae
Alcoholism upper quadrant pain Clinical history and Piperacillin-tazobactam,
Acute pancrea??s Enterobacteriaceae
Hypercalcaemia Nausea/vomiIng examinaIon based on carbapenem, cefepime-
Enterococcus spp.
MedicaIons Cullen’s and Grey- symptoms metronidazole (a`er 1st
Streptococcus spp.
Turner’s signs CT/MRI/US week)
AspiraIon, surgery,
supporIve therapy
