Pyuria
| Pyuria | |
|---|---|
 | |
| White blood cells seen under a microscope from a urine sample. | |
| Pronunciation | |
| Specialty | Urology |
Pyuriais the condition ofurinecontaining white blood cells orpus.Defined as the presence of 6-10 or moreneutrophilsper high power field of unspun, voided mid-stream urine, it can be a sign of a bacterialurinary tract infection.Pyuria may be present in people withsepsis,or in older people withpneumonia.Others additionally require discoloration, clouding or change in the smell of urine for apyuriato be present. Without these additional features, there is said to beleukocyturia.
Sterile pyuria[1]is urine which containswhite blood cellswhile appearing sterile by standardculturingtechniques. It is often caused by sexually transmitted infections, such as gonorrhea, or viruses which will not grow in bacterial cultures. Sterile pyuria is listed as a side effect from some medications such asparacetamol (acetaminophen).Its occurrence is also associated with certain disease processes, such asKawasaki diseaseand genitourinarytuberculosis.[2]However, there are many known causes, includingsystemicorinfectiousdisease, structural and physiological reasons, intrinsic kidney pathology, or drugs.[2]
Leukocyturia
[edit]Under normal conditions, fewer than two million leukocytes are expelled in urine per day. A number greater than two million is called leucocyturia and can be determined when determining theAddis count.[3]
However, this method requires a 24-hour urine collection, so it is not practical. Currently, the number of leukocytes is estimated under the microscope for which morning urine is taken. It has been arbitrarily assumed that a number of over 4-5 leukocytes in the field of vision of the microscope indicates leukocyturia.[4]
At the moment, there are also quick test strips available, allowing after wetting a special diagnostic bar, the detection of granulocytes in the urine, as evidenced by the color change of the test strip.[5]The principle of their operation is based on the detection ofgranulocytesesterases,including leukocytes. This method, however, is burdened with a large number of false positive results (use ofantibiotics,such asimipenem,meropenem,clavulanic acid,which is sometimes combined withpenicillinderivatives) or false negative (gentamicin,cefalexin,glycosuria,proteinuria).[citation needed]
Leukocyturia is a laboratory symptom of many diseases likeglomerulonephritisorpyelonephritis.It may occur in the case of diseases of the urinary tract, reproductive system and diseases of the abdominal organs.[6]Leukocyturia is mostly a sign ofurinary tract infection,especially if significant bacteriuria is found (for most people, the number of bacteria in a culture is > 10^5) and other symptoms associated with passing urine.[7]The presence of leukocyturia does not indicate the need for antimicrobial therapy yet.[citation needed]
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See also
[edit]References
[edit]- ^Gilbert J. Wise & Peter N. Schlegel (March 12, 2015)."Sterile Pyuria".N Engl J Med.372(11): 1048–1054.doi:10.1056/NEJMra1410052.PMID25760357.
- ^abDieter RS (2000). "Sterile pyuria: a differential diagnosis".Compr Ther.26(3): 150–2.doi:10.1007/s12019-000-0001-1.PMID10984817.S2CID11629600.
- ^Vasan, R.S. (1998).Textbook of Medicine.Orient Blackswan. p. 939.ISBN9788125012665.
- ^Bagga (2009).Urinary Tract Infections And Anomalies.Elsevier Health Sciences. p. 4.ISBN9788131223710.
- ^Hofmann, Walter; Aufenanger, Johannes; Hoffmann, Georg (2016).Laboratory Diagnostic Pathways: Clinical Manual of Screening Methods and...Walter de Gruyter GmbH & Co KG. p. 142.ISBN9783110455083.
- ^Von Forstner, Manfred Schmidl (1986).Laboratory testing in veterinary medicine diagnosis and clinical monitoring.Boehringer Mannheim. p. 20.
- ^Archives of Medical Research, Volume 31.Instituto Mexicano del Seguro Social. 2000. p. 214.
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