According to Cook,1 infections of the urinary tract are in general poorly treated. It is important to determine first whether an infection of the urinary tract is actually present and if so whether it is an uncomplicated infection or is secondary to some coexisting lesion such as calculus, tumor, obstruction, or scar. If such a secondary lesion exists, treatment directed primarily at the infection will not cure the condition.
Acute cystitis is the commonest of the urinary tract infections, and about 80% of such infections are caused by gram-negative bacilli.2 For this reason it is well to make a gram stain of the sediment obtained by centrifuging a specimen of the patient's urine collected under sterile conditions. Efforts to avoid introducing contaminants cannot be overemphasized, because many unfortunate patients with no infection have been treated for cystitis when the organisms found (usually Proteus organisms, Streptococcus faecalis, or Pseudomonas
URINARY INFECTIONS. JAMA. 1956;160(3):210–211. doi:10.1001/jama.1956.02960380058015
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