A 43-year-old woman had been treated repeatedly for dysuria and urinary frequency. Each episode improved with antibiotics, then another infection appeared weeks later.
During the latest visit she casually mentioned increased thirst and getting up several times at night to pass urine.
The overlooked clue
A random capillary glucose was markedly elevated.
Further testing confirmed previously undiagnosed diabetes mellitus.
The diagnostic twist
Recurrent infections may be the presenting clue to an underlying metabolic problem. Hyperglycemia can impair host defense and promote urinary and genital infections.
Clinical pearls
- Repeated common infections deserve a search for predisposing factors.
- Ask about thirst, polyuria, weight change and family history.
- Do not allow repeated prescriptions to replace a broader clinical review.
- Controlling the underlying diabetes is part of infection prevention.
Take-home message
The third “simple UTI” may be telling you to look beyond the urinary tract.
Educational note: This is a fictionalized/composite teaching case created for clinical reasoning. It is not a record of an identifiable patient and is not a substitute for local protocols, specialist advice or patient-specific clinical judgement.