Urinary tract infections in the emergency department

Urinary tract infection (UTI) is a commonly encountered clinical condition in the emergency department (ED). The spectrum of disease severity as seen by emergency physicians is wide and can range from uncomplicated cystitis to pyelonephritis and fulminant urosepsis syndrome. Infectious disease (ID) specialists, on the other hand, are most often consulted on patients with complicated UTIs and those who are admitted to the hospital with more severe illness. This article is written from the perspective of the evaluation and initial management of UTIs in the ED. The pitfalls and clinical dilemmas pertinent to emergency physicians that are not often encountered by ID specialists are highlighted.