Urinary Tract Infections
Mucocutaneous Lymph Node Syndrome
Sensitivity and Specificity
Urinary infection in children in general practice: a laboratory view. (1/55)Children with urinary infection present at first to their general practitioners; paediatricians to whom they may be referred must assess the validity of the bacteriological diagnosis made at that time. With this in mind an analysis has been made of the laboratory findings in 2204 mid-stream urine specimens from 1586 children between the ages of two and 12 years examined at the request of their general practitioners during the course of one year. The contamination rate was shown to be low; 8% of the specimens from boys and 19% of those from girls showed definite infection, and the ratio of infections in boys to girls was 1:4. There was a considerable difference in the infecting organisms in the sexes. Analysis of the reasons for sending the specimens revealed that a high percentage of children who complained of urinary symptoms did not have infection. Of the children complaining of enuresis only there was a significantly greater incidence of infection in girls than in boys. In the absence of any large studies of urinary infection in domiciliary practice, data from a laboratory which serves many practitioners can contribute to knowledge of the disease. (+info)
Anterior urethral valve in an adolescent boy. (2/55)A 14 year old boy with a relatively uncommon anterior urethral valve is described herein. (+info)
A prospective study of asymptomatic bacteriuria in sexually active young women. (3/55)BACKGROUND: Asymptomatic bacteriuria is common in young women, but little is known about its pathogenesis, natural history, risk factors, and temporal association with symptomatic urinary tract infection. METHODS: We prospectively evaluated 796 sexually active, nonpregnant women from 18 through 40 years of age over a period of six months for the occurrence of asymptomatic bacteriuria (defined as at least 10(5) colony-forming units of urinary tract pathogens per milliliter). The women were patients at either a university student health center or a health maintenance organization. Periodic urine cultures were taken, daily diaries were kept, and regularly scheduled interviews were performed. Escherichia coli strains were tested for hemolysin, the papG genotype, and the ribosomal RNA type. RESULTS: The prevalence of asymptomatic bacteriuria (the proportion of urine cultures with bacteriuria in asymptomatic women) was 5 percent (95 percent confidence interval, 4 percent to 6 percent) among women in the university group and 6 percent (95 percent confidence interval, 5 percent to 8 percent) among women in the health-maintenance-organization group. Persistent asymptomatic bacteriuria with the same E. coli strain was rare. Symptomatic urinary tract infection developed within one week after 8 percent of occasions on which a culture showed asymptomatic bacteriuria, as compared with 1 percent of occasions when asymptomatic bacteriuria was not found (P<0.001). Asymptomatic bacteriuria was associated with the same risk factors as for symptomatic urinary tract infection, particularly the use of a diaphragm plus spermicide and sexual intercourse. CONCLUSIONS: Asymptomatic bacteriuria in young women is common but rarely persists. It is a strong predictor of subsequent symptomatic urinary tract infection. (+info)
Evaluation of the accuracy of leukocyte esterase testing to detect pyuria in young febrile children: prospective study. (4/55)OBJECTIVE: To study the accuracy and clinical application of the dipstick leukocyte esterase test in the detection of pyuria in young febrile children suspected to have urinary tract infection. DESIGN: Prospective study. SETTING: Regional hospital, Hong Kong. PATIENTS: Urine samples were taken from 215 children younger than 2 years who were suspected to have urinary tract infection (fever without an obvious focus of infection). MAIN OUTCOME MEASURES: The accuracy of the dipstick leukocyte esterase test in detecting significant pyuria defined as a leukocyte count >or=10 mm(3) (>or=0.01 x 10(9) /L). RESULTS: Two hundred and fifty-four urine samples collected by bag, midstream clean-catch, suprapubic bladder aspiration, or urethral catheterization were examined. Using urine microscopy results as a reference, the sensitivity and specificity of the leukocyte esterase test in detecting significant pyuria were found to be 72.0% and 85.8%, respectively; the positive and negative predictive values were 55.4% and 92.6%, respectively; and the positive and negative likelihood ratios were 5.1 and 0.3, respectively. CONCLUSIONS: The dipstick leukocyte esterase test cannot accurately detect pyuria in young febrile children. It is also not appropriate as a screening test to exclude pyuria, reduce the need for the microscopic examination of urine, or indicate when a hospital admission for probable urinary tract infection is needed. (+info)
Asymptomatic pyuria in diabetic women. (5/55)The aim of the present study was to determine the prevalence of and the host factors for asymptomatic pyuria (ASP) in women with type 2 diabetes. The study included 179 type 2 diabetic women and consecutive 455 non-diabetic women attending as out-patients in 1996. Patients with symptoms of a urinary tract infection were excluded. ASP was defined as the presence of more than 10 leukocytes/high-power field in a random urine sample. Diabetic women more often had ASP than non-diabetic women (27.9 vs. 15.8%, P<0.001). The prevalence of ASP was significantly increased in patients with a duration of diabetes exceeding 15 years (0 approximately 4 years; 20.3%, 5 approximately 9 years; 24.3%, 10 approximately 14 years; 23.8%, and > or =15 years; 46.3%). No differences were evident in HbA(1C) between diabetic patients without ASP and those with ASP. Diabetic women with ASP more often had diabetic retinopathy, neuropathy, nephropathy, cerebrovascular disease, ischemic heart disease, and hyperlipidemia than those without ASP. However, no statistically significant differences were evident in the prevalence of hypertension, constipation, or dementia. As the degree of neuropathy increases, it is accompanied by an increasing prevalence of ASP (none, 21.4%; blunt tendon reflexes, 24.5%; symptomatic, 50.0%; and gangrene, 66.6%). The prevalence of ASP was significantly increased in the patients with proliferative diabetic retinopathy (none, 23.2%; background, 29.4%; pre-proliferative, 18.2%; and proliferative, 50.0%). As the degree of nephropathy increases, it is accompanied by an increasing prevalence of ASP (none, 20.0%; microalbuminuria, 31.9%; macroalbuminuria, 37.0%; and renal failure, 60.0%). Thus, the prevalence of ASP is increased in women with diabetes and increased with longer duration of diabetes but was not affected by glucose control. The incidence of ASP increases significantly as diabetic microangiopathy becomes severer. (+info)
Indinavir-associated interstitial nephritis and urothelial inflammation: clinical and cytologic findings. (6/55)The objective of the present study was to characterize the genitourinary syndromes that accompany indinavir-associated pyuria. Of 23 indinavir-treated patients with persistent pyuria, 4 had isolated interstitial nephritis, 10 had both interstitial nephritis and urothelial inflammation, 7 had isolated urothelial inflammation, and 2 had pyuria with nonspecific urinary tract inflammation. A total of 21 patients had multinucleated histiocytes identified by cytologic testing of urine specimens. Urine abnormalities resolved in all 20 patients who stopped receiving indinavir therapy. Pyuria continued in the 3 patients who continued receiving indinavir. Six patients had elevated serum creatinine levels, which returned to baseline levels when indinavir was discontinued. In conclusion, indinavir-associated pyuria was frequently associated with evidence of interstitial nephritis and/or urothelial inflammation, multinucleated histiocytes were commonly present in urine specimens, and cessation of indinavir therapy was associated with prompt resolution of urine abnormalities. (+info)
Use of urinary gram stain for detection of urinary tract infection in childhood. (7/55)In this study, urinary culture, urinary Gram stain, and four tests within the urinalysis, leukocyte esterase, nitrite, microscopyfor bacteria, and microscopyforpyuria, were examined in 100 children with symptoms suggesting urinary tract infection. Our purpose was to determine the validity of the urinary Gram stain compared with a combination of pyuria plus Gram stain and overall urinalysis (positiveness of nitrite, leukocyte esterase, microscopy for bacteria, or microscopy for white blood cell). Of 100 children, aged two days to 15 years, 70 (70 percent) had a positive urinary culture: 40 girls (57 percent) and 30 boys (43 percent). Escherichia coli was the most common isolated agent. The sensitivity and specificity of the urinary Gram stain were 80 percent and 83 percent, and that of the combination of pyuria plus Gram stain 42 percent and 90 percent, and that of the overall urinalysis 74 percent and 3.5 percent respectively. Our findings revealed that neither method of urine screen should substitute for a urine culture in the symptomatic patients in childhood. (+info)
Actinobaculum urinale sp. nov., from human urine. (8/55)A hitherto undescribed Actinomyces-like bacterium was isolated from human urine. Based on its biochemical characteristics, the unidentified bacterium did not correspond to any currently described Actinomyces species or related taxa. Comparative 16S rRNA gene sequencing showed that the unknown bacterium exhibits a specific phylogenetic association with the genus Actinobaculum, but a sequence divergence of > 5% from the two currently recognized members of this genus, Actinobaculum schaalii and Actinobaculum suis, demonstrates that it represents a distinct species. Based on both phenotypic and 16S rRNA gene sequence considerations, it is proposed that the unknown bacterium from urine should be classified as a novel species, Actinobaculum urinale sp. nov. The type strain of Actinobaculum urinale is CCUG 46093(T) (= CIP 107424(T)). (+info)
Bacteriuria is a medical condition characterized by the presence of bacteria in the urine. It is typically defined as the presence of at least 100,000 colony-forming units (CFUs) of bacteria per milliliter of urine. Bacteriuria can be asymptomatic, meaning that the individual does not experience any symptoms, or it can cause symptoms such as a strong, persistent urge to urinate, frequent urination, pain or burning during urination, cloudy or strong-smelling urine, and fever or chills. Bacteriuria can be caused by a variety of bacteria, including Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus saprophyticus. It is often associated with urinary tract infections (UTIs), which can range from mild to severe and can affect any part of the urinary tract, including the kidneys, ureters, bladder, and urethra. Treatment for bacteriuria typically involves antibiotics to eliminate the bacteria causing the infection. In some cases, additional treatment may be necessary to prevent the recurrence of the infection or to address any underlying medical conditions that may have contributed to the development of bacteriuria.
Urinary Tract Infections (UTIs) are infections that occur in any part of the urinary system, including the kidneys, ureters, bladder, and urethra. UTIs are commonly caused by bacteria, such as Escherichia coli (E. coli), and can affect people of all ages, but are more common in women than men. The symptoms of UTIs can vary depending on the location of the infection, but may include a strong, persistent urge to urinate, a burning sensation while urinating, passing frequent, small amounts of urine, cloudy or strong-smelling urine, and abdominal pain or discomfort. UTIs can be treated with antibiotics, which can help to clear the infection and relieve symptoms. It is important to seek medical attention if you suspect you have a UTI, as untreated infections can lead to more serious complications, such as kidney damage or sepsis.
Pyuria is the presence of white blood cells (leukocytes) in the urine. It is typically a sign of an infection in the urinary tract, such as a bladder or kidney infection. Pyuria can also be caused by other conditions, such as kidney stones, certain medications, or inflammatory bowel disease. In some cases, pyuria may be a normal finding and not indicate an underlying problem. However, if pyuria is accompanied by other symptoms, such as pain or fever, it is important to seek medical attention to determine the cause and receive appropriate treatment.
Tuberculosis, renal, also known as renal tuberculosis, is a type of tuberculosis that affects the kidneys. It is caused by the bacterium Mycobacterium tuberculosis, which can spread to the kidneys from other parts of the body, such as the lungs or lymph nodes. Renal tuberculosis can cause a variety of symptoms, including blood in the urine, flank pain, and high blood pressure. It can also lead to kidney damage or failure if left untreated. Diagnosis of renal tuberculosis typically involves a combination of medical history, physical examination, and imaging studies such as ultrasound, CT scan, or MRI. A biopsy of the kidney may also be necessary to confirm the diagnosis. Treatment for renal tuberculosis typically involves a combination of antibiotics to kill the bacteria and medications to manage symptoms and prevent complications. In severe cases, surgery may be necessary to remove damaged kidney tissue or to repair kidney damage.
Vulvitis is a medical condition that refers to the inflammation or irritation of the vulva, which is the external female genitalia. The vulva includes the labia majora (outer lips), labia minora (inner lips), clitoris, vaginal opening, and Bartholin's glands. Vulvitis can be caused by a variety of factors, including infections, allergies, irritants, trauma, and certain medical conditions such as diabetes or autoimmune disorders. Symptoms of vulvitis may include redness, swelling, itching, burning, pain, discharge, and difficulty urinating or having sex. Treatment for vulvitis depends on the underlying cause and may include medications such as antibiotics, antifungal creams, or corticosteroids, as well as lifestyle changes such as avoiding irritants or wearing loose-fitting clothing. In some cases, a healthcare provider may recommend further testing or refer the patient to a specialist for further evaluation and treatment.
Pyelonephritis, xanthogranulomatous is a rare and chronic form of kidney infection that involves the accumulation of yellowish, fatty deposits in the renal parenchyma, or. This condition is characterized by the presence of xanthogranulomas, which are collections of macrophages and lipid-laden foam cells, in the kidney. Xanthogranulomas are typically associated with chronic inflammation and can lead to the destruction of kidney tissue. Pyelonephritis, xanthogranulomatous is often caused by a bacterial infection that spreads from the urinary tract to the kidney. The bacteria can cause inflammation and damage to the renal parenchyma, leading to the formation of xanthogranulomas. Other factors that may contribute to the development of this condition include immune system disorders, genetic factors, and certain medications. Symptoms of pyelonephritis, xanthogranulomatous may include fever, chills, nausea, vomiting, and pain in the back or side. In some cases, there may be no symptoms at all. Diagnosis is typically made through imaging studies, such as ultrasound or CT scan, and through the examination of kidney tissue obtained through a biopsy. Treatment for pyelonephritis, xanthogranulomatous typically involves antibiotics to treat the underlying bacterial infection. In some cases, surgery may be necessary to remove damaged kidney tissue or to treat complications, such as abscesses or kidney stones. It is important to seek prompt medical attention if you suspect you may have this condition, as it can lead to serious complications if left untreated.
Glycosuria refers to the presence of glucose (sugar) in the urine. It is a common sign of diabetes mellitus, a chronic condition characterized by high blood sugar levels. In people with diabetes, the body is unable to produce enough insulin or use it effectively, leading to high levels of glucose in the bloodstream. This excess glucose can then be filtered through the kidneys and excreted in the urine, resulting in glycosuria. Glycosuria can also occur in non-diabetic individuals, such as during pregnancy, after a high-carbohydrate meal, or as a side effect of certain medications. However, persistent glycosuria in the absence of other causes is typically a sign of diabetes or prediabetes and should be evaluated by a healthcare provider.
Nephritis, interstitial is a type of kidney disease that affects the interstitial space, which is the space between the cells and blood vessels in the kidneys. It is characterized by inflammation and damage to the interstitial tissue, which can lead to scarring and a decrease in kidney function. There are several different types of interstitial nephritis, including acute interstitial nephritis, chronic interstitial nephritis, and drug-induced interstitial nephritis. Symptoms of interstitial nephritis may include fatigue, nausea, vomiting, and changes in urine output. Treatment typically involves addressing the underlying cause of the inflammation and managing symptoms.
Esterases are a class of enzymes that catalyze the hydrolysis of esters, which are compounds formed by the reaction of an acid and an alcohol. In the medical field, esterases are important in the metabolism of many drugs and other substances, as well as in the breakdown of fats and other lipids in the body. There are many different types of esterases, including carboxylesterases, lipases, and cholinesterases. Carboxylesterases are found in many tissues throughout the body and are involved in the metabolism of a wide range of drugs and other substances. Lipases are enzymes that break down fats and other lipids, and are important in the digestion and absorption of dietary fats. Cholinesterases are enzymes that break down the neurotransmitter acetylcholine, and are important in the regulation of muscle movement and other functions. Esterases can be inhibited or activated by various substances, and changes in their activity can have important effects on the body. For example, certain drugs can inhibit the activity of esterases, leading to an accumulation of drugs or other substances in the body and potentially causing toxicity. On the other hand, esterase activators can increase the activity of these enzymes, leading to faster metabolism and elimination of drugs and other substances from the body.
Cystitis is a medical condition that refers to the inflammation of the bladder. It is a common condition that can affect people of all ages and genders. The symptoms of cystitis can include a frequent and urgent need to urinate, a burning sensation when urinating, and pain in the lower abdomen or back. Cystitis can be caused by a variety of factors, including bacterial infections, viruses, and irritants such as certain chemicals or detergents. Treatment for cystitis typically involves antibiotics to treat bacterial infections, and measures to relieve symptoms such as drinking plenty of fluids and avoiding irritants. In some cases, more serious forms of cystitis may require hospitalization for treatment.
Mucocutaneous Lymph Node Syndrome (MLNS), also known as Kawasaki disease, is a rare but serious illness that primarily affects children under the age of five. It is characterized by a fever that lasts for at least five days, accompanied by symptoms such as redness and swelling of the hands and feet, a rash on the skin, and inflammation of the lymph nodes in the neck, armpits, and groin. MLNS can also cause inflammation of the coronary arteries, which can lead to serious complications such as heart failure or a heart attack. The exact cause of MLNS is not known, but it is thought to be triggered by an infection or an immune response to a virus or bacteria. Treatment for MLNS typically involves high-dose intravenous immunoglobulin (IVIG) therapy, which can help reduce inflammation and prevent complications. In some cases, corticosteroids may also be used to reduce inflammation. Most children with MLNS recover fully, but some may experience long-term complications such as heart problems or joint stiffness.
Fever is a medical condition characterized by an elevated body temperature above the normal range of 36.5-37.5°C (97.7-99.5°F). It is typically a response to an infection or inflammation in the body, and can also be caused by certain medications or other medical conditions. Fever is usually accompanied by other symptoms such as chills, sweating, fatigue, headache, muscle aches, and loss of appetite. While a fever can be uncomfortable, it is generally not considered a serious medical condition in itself, and can be a sign that the body is fighting off an infection. In some cases, a fever may be a sign of a more serious underlying condition, such as sepsis or meningitis. If a fever persists for more than a few days, or if it is accompanied by other severe symptoms, it is important to seek medical attention.
Anthony L. Komaroff
List of ICD-9 codes 580-629: diseases of the genitourinary system
Lower urinary tract symptoms
Sheila Singh Paul
Urine test strip
List of MeSH codes (C01)
List of MeSH codes (C12)
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- In those with positive or suspicious urine cultures, bacteriuria or pyuria, urine culture was repeated. (who.int)
- During follow-up, symptomatic women provided urine samples for detection of pyuria and/or bacteriuria and received an appropriate antibiotic prescription. (biomedcentral.com)
- Secondary outcomes included symptomatic urinary tract infection with pyuria or bacteriuria. (biomedcentral.com)
- Sometimes without symptoms (only pyuria and bacteriuria). (urology-textbook.com)
- A child was referred to the nephrology clinic with several years' history of microscopic hematuria and a single episode of sterile pyuria. (appliedradiology.com)
- NEW YORK (Reuters Health) - In children with neurogenic bladders who require clean intermittent catheterization (CIC), Enterococcus bacteria may grow in urine culture without pyuria (pus in the urine typically from bacterial infection) or positive leukocyte esterase, a new study suggests. (medscape.com)
- To see if an association exists between pyuria and the type of uropathogen in CIC-dependent children, they took a look back at 2,420 urinalysis and urine culture results from patients aged 18 and younger with neurogenic bladder managed at one center. (medscape.com)
- They found that the growth of Enterococcus species on urine culture was associated with lower odds of both microscopic pyuria and leukocyte esterase, while Proteus mirabilis was associated with increased odds of both pyuria and leukocyte esterase. (medscape.com)
- It is a urinary condition in which there is an appearance of pus cells in urine and the medical term for pus cells in urine is pyuria. (homeoexpert.com)
- However, children with neurogenic bladders who require CIC often have chronic urethral inflammation, "which may confound the association between pyuria and uropathogens," Dr. Forster and colleagues point out. (medscape.com)
- Noninfectious causes of pyuria include uric acid and hypercalcemic nephropathy, lithium and heavy metal toxicity, sarcoidosis, interstitial cystitis, polycystic kidney disease, genitourinary malignancy, and renal transplant rejection. (medscape.com)
- Dorfman M, Chan SB, Hayek K, Hill C. Pyuria and urine cultures in patients with acute renal colic. (britishjournalofnursing.com)
- A recent study in the general pediatric population (with a normal genitourinary tract) found that some specific uropathogens (Enterococcus and Klebsiella species, and Pseudomonas aeruginosa) were less apt to be associated with pyuria than Escherichia coli. (medscape.com)
- For the patients with pyuria, In addition to diarrhoea, 92 patients had mixed growth or 103-105 colonies/mL of vomiting and 32 had fever. (who.int)
Bacteriuria and pyuria2
- Symptomatic UTIs in children present as unexplained fever ≥ 38℃, abnormal urinalysis results such as pyuria, and confirmed diagnosis of significant bacteriuria of ≥10 5 colony forming units of bacteria per milliliter (CFU/mL) in one urine specimen [ 13 ]. (chikd.org)
- The purpose of this study is to investigate the prevalence of postoperative bacteriuria, pyuria and urine culture in patients with an orthotopic sigmoid colon neobladder replacement. (histonedemethylase-signal.com)
- Urine samples for bacteriuria, pyuria and urine culture, if necessary, were collected at 1, 3, 6, 9 and 12 months after surgery and the presence of blood culture and antibiotic-resistant strains, and their treatments on positive urine culture cases were investigated. (histonedemethylase-signal.com)
- Of 209 for bacteriuria and 207 for pyuria urine samples with evaluable data, 95 (45.5%) were positive for bacteriuria and 76 (36.7%) had pyuria (10 or more white blood cells per high-power field). (histonedemethylase-signal.com)
- A mid-stream urine specimen with: a a machine-read dipstick positive for nitrite AND b evidence of pyuria as defined by either: i. (cgelectric.hu)
- The urine is cloudy due to the pyuria (pus cells) and bacteriuria, and may contain visible amounts of blood (macroscopic haematuria). (brainkart.com)
- Sterile pyuria (pus cells without a positive culture) may be caused by antibiotic treatment, stones, drugs such as NSAIDs and occasionally tuberculosis. (brainkart.com)
- The incidence of pyuria significantly decreased over time (P=0.041) but that of bacteriuria did not (P=0.107). (histonedemethylase-signal.com)
- In conclusion, these findings suggest that physicians taking care of sigmoid colon neobladder patients need to be aware of these high ratios of bacteriuria, pyuria and UTI, including bacteremia. (histonedemethylase-signal.com)
- In addition to aseptic pyuria, patients with a suspected UTI on kidney ultrasound and dimercaptosuccinic acid (DMSA) kidney scan were included in this study, while patients with insufficient medical records were excluded from the study. (chikd.org)
- Pyuria without BACTERIURIA can be caused by TUBERCULOSIS , stones, or cancer. (bvsalud.org)
- Bacteriuria plus pyuria is highly prevalent among older women living in nursing homes. (nih.gov)
- To test the effect of 2 oral cranberry capsules once a day on presence of bacteriuria plus pyuria among women residing in nursing homes. (nih.gov)
- Double-blind, randomized, placebo-controlled efficacy trial with stratification by nursing home and involving 185 English-speaking women aged 65 years or older, with or without bacteriuria plus pyuria at baseline, residing in 21 nursing homes located within 50 miles (80 km) of New Haven, Connecticut (August 24, 2012-October 26, 2015). (nih.gov)
- Noninfectious causes of pyuria include uric acid and hypercalcemic nephropathy, lithium and heavy metal toxicity, sarcoidosis, interstitial cystitis, polycystic kidney disease, genitourinary malignancy, and renal transplant rejection. (medscape.com)