Urine 2

Kelly Fish, aged 19 – you have dipped her urine the results are below in the picture.

Kelly has slight dysuria, no other symptoms.

She has left a note saying she has another urine infection and wants anti-biotics.


– She says her urine smells and stings when passing it for the last 24 hours.
There is no abdominal or back pain.

– No fever or haematuria.

– No vomiting or diarrhoea.

– She has had 4 similar episodes in the last 8 months and was given anti-biotics. She presented every time at out of hours at night so an MSU has not confirmed the infection. She is complaining of painful intercourse.

Bearing in mind the age, gender of Kelly think about other differential diagnoses

  • What would lead you to rule in or out urinary infection?
  • What assessment criteria would you use to come up with a differential diagnoses?
  • What would alert you to any red flags?
  • If anti-biotics are not the most appropriate treatment how would you convince Kelly that she may not need anti-biotics?
  • She is otherwise well, no fever, back pain or vomiting.
  • Document your consultation with Kelly. Use the link below to help with your management.

Document in your workbook.