All right, so welcome back to the Internet Book of Critical Care podcast. I'm here with Adam Thomas.

We're going to talk about catheter associated during a track infection and whether this exists and what it is.

So say the acronym for me, Josh. Cowdy. I'm going to go with Cowdy. COVID, Cowdy. People from the East Coast, they have problems with their seabirds, I guess.

Out here, I think we say caudy, but that's to each their own.

Yeah, we can agree to disagree.

On board. So this is part of that septic workup or the fever of the unknown origin.

We talk about adenosium at rounds every morning so important things are

definition definition definition and what the diagnostic criteria for this are

we'll go into management and then I'll work up but Josh you already alluded to this

you want to say this is not real IDSA might argue with you but it's very complex

why is this overreported just to start out with some basic principles.

So the urinary tract infections can be split into roughly two types of infections. So there's cystitis,

which is your lower urinary tract infection. And pyloinophritis, which is like an ascending

urinary tract infection and bacteria are often spilling into the blood. And cystitis typically causes

the local symptoms, frequency, dishears, stuff like that. It typically does not cause fever, sepsis, or honestly like anything that

would cause me to get excited or intensivist to get excited about. We should underscore that,

Josh. That urepsis caused from cystitis an immunocompetent patient is extremely rare.

Exactly. The problem occurs when infection ascends to the kidneys and that causes pionaphritis

and bacteria start kind of filtering into the blood.

I mean, that causes the classic euricepsis, bacteremia, stuff that does get us excited and

that is important.

And this is really a key differentiation.

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