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== Pyuria Differential Diagnosis == | == Pyuria Differential Diagnosis == | ||
'''Differentiating the diseases that can cause pyuria:'''<ref name="WiseLongo2015">{{cite journal|last1=Wise|first1=Gilbert J.|last2=Longo|first2=Dan L.|last3=Schlegel|first3=Peter N.|title=Sterile Pyuria|journal=New England Journal of Medicine|volume=372|issue=11|year=2015|pages=1048–1054|issn=0028-4793|doi=10.1056/NEJMra1410052}}</ref><ref name="Stamm1983">{{cite journal|last1=Stamm|first1=Walter E.|title=Measurement of pyuria and its relation to bacteriuria|journal=The American Journal of Medicine|volume=75|issue=1|year=1983|pages=53–58|issn=00029343|doi=10.1016/0002-9343(83)90073-6}}</ref><ref name="GroahPerez-Losada2015">{{cite journal|last1=Groah|first1=Suzanne|last2=Perez-Losada|first2=Marcos|last3=Caldovic|first3=Ljubica|last4=Ljungberg|first4=Inger|last5=Sprague|first5=Bruce|last6=Castro-Nallar|first6=Eduardo|last7=Shah|first7=Neel|last8=Hsieh|first8=Michael|last9=Pohl|first9=Hans|title=MP20-08 PYURIA AND ASYMPTOMATIC BACTERIURIA IS ASSOCIATED WITH NOVEL AND SPECIFIC URINE MICROBIOMES|journal=The Journal of Urology|volume=193|issue=4|year=2015|pages=e226|issn=00225347|doi=10.1016/j.juro.2015.02.980}}</ref> | '''Differentiating the diseases that can cause pyuria:'''<ref name="WiseLongo2015">{{cite journal|last1=Wise|first1=Gilbert J.|last2=Longo|first2=Dan L.|last3=Schlegel|first3=Peter N.|title=Sterile Pyuria|journal=New England Journal of Medicine|volume=372|issue=11|year=2015|pages=1048–1054|issn=0028-4793|doi=10.1056/NEJMra1410052}}</ref><ref name="Stamm1983">{{cite journal|last1=Stamm|first1=Walter E.|title=Measurement of pyuria and its relation to bacteriuria|journal=The American Journal of Medicine|volume=75|issue=1|year=1983|pages=53–58|issn=00029343|doi=10.1016/0002-9343(83)90073-6}}</ref><ref name="GroahPerez-Losada2015">{{cite journal|last1=Groah|first1=Suzanne|last2=Perez-Losada|first2=Marcos|last3=Caldovic|first3=Ljubica|last4=Ljungberg|first4=Inger|last5=Sprague|first5=Bruce|last6=Castro-Nallar|first6=Eduardo|last7=Shah|first7=Neel|last8=Hsieh|first8=Michael|last9=Pohl|first9=Hans|title=MP20-08 PYURIA AND ASYMPTOMATIC BACTERIURIA IS ASSOCIATED WITH NOVEL AND SPECIFIC URINE MICROBIOMES|journal=The Journal of Urology|volume=193|issue=4|year=2015|pages=e226|issn=00225347|doi=10.1016/j.juro.2015.02.980}}</ref><ref name="ShaikhShope2016">{{cite journal|last1=Shaikh|first1=N.|last2=Shope|first2=T. R.|last3=Hoberman|first3=A.|last4=Vigliotti|first4=A.|last5=Kurs-Lasky|first5=M.|last6=Martin|first6=J. M.|title=Association Between Uropathogen and Pyuria|journal=PEDIATRICS|volume=138|issue=1|year=2016|pages=e20160087–e20160087|issn=0031-4005|doi=10.1542/peds.2016-0087}}</ref> | ||
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Revision as of 19:26, 29 May 2018
Pyuria Differential Diagnosis
Differentiating the diseases that can cause pyuria:[1][2][3][4]
| Category | Disease | Clinical manifestations | Para−clinical findings | Gold standard for diagnosis | Associated findings | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical examination | ||||||||||||||||||||||||
| Lab Findings | Imaging | ||||||||||||||||||||||||
| Pain | Fever | N/V | Urinary symptoms | BP | Edema | Other | CBC | Electrolytes | Urinalysis | Ultrasound | CT scan | Other | |||||||||||||
| Dysuria | Frequency | Urgency | Gross hematuria | Cell | Cast | Bacteriuria | Culture | Other | |||||||||||||||||
| Infectious diseases | UTI | Bacterial | Asymptomatic bacteriuria | − | − | − | − | − | − | − | Nl | − | − | Nl | Nl | − | − | + | − | − | − | − | − | Urinalysis |
|
| Cystitis | − | − | − | + | + | + | − | Nl | − | − | Nl | Nl | ↑ | − | + | + | Nitrite + | − | − | − | Urinalysis | ||||
| Pyelonephritis | + | + | + | + | + | + | − | Nl | − | − | WBC ↑ | Nl | ↑ | WBC cast | + | + | Nitrite + | − | − | − | Clinical manifestation + urinalysis | ||||
| Viral | |||||||||||||||||||||||||
| Tuberculosis | + | ||||||||||||||||||||||||
| Fungal | |||||||||||||||||||||||||
| STD | Chlamydia | ||||||||||||||||||||||||
| Gonococcus | |||||||||||||||||||||||||
| Ureaplasma urealyticum | |||||||||||||||||||||||||
| HSV-2 | |||||||||||||||||||||||||
| Herpes zoster | |||||||||||||||||||||||||
| HPV | |||||||||||||||||||||||||
| HIV | |||||||||||||||||||||||||
| Prostatitis | |||||||||||||||||||||||||
| Balanitis | |||||||||||||||||||||||||
| PID | |||||||||||||||||||||||||
| Appendicitis | |||||||||||||||||||||||||
| Non−infectious diseases | Urinary tract disorders | Urinary catheterization | |||||||||||||||||||||||
| Urinary tract stone | |||||||||||||||||||||||||
| Urinary tract neoplasm | |||||||||||||||||||||||||
| Urinary fistula | |||||||||||||||||||||||||
| Interstitial cystitis | |||||||||||||||||||||||||
| Vesicoureteral reflux | |||||||||||||||||||||||||
| Hydronephrosis | |||||||||||||||||||||||||
| Renal diseases | Polycystic kidney disease | ||||||||||||||||||||||||
| Renal vein thrombosis | |||||||||||||||||||||||||
| Interstitial nephritis | |||||||||||||||||||||||||
| Papillary necrosis | |||||||||||||||||||||||||
| IgA nephropathy | |||||||||||||||||||||||||
| Renal transplant rejection | |||||||||||||||||||||||||
| Systemic disease | Malignant hypertension | ||||||||||||||||||||||||
| Diabetic nephropathy | |||||||||||||||||||||||||
| Sickle cell disease | |||||||||||||||||||||||||
| Sarcoidosis | |||||||||||||||||||||||||
| Systemic lupus erythematosus | |||||||||||||||||||||||||
| Sjögren’s syndrome | |||||||||||||||||||||||||
| Kawasaki's disease | |||||||||||||||||||||||||
| Graft versus host disease (GVHD) | |||||||||||||||||||||||||
| Medication/toxin | Analgesic nephropathy | ||||||||||||||||||||||||
| Contrast-induced nephropathy | |||||||||||||||||||||||||
| Glucocorticoids | |||||||||||||||||||||||||
| Toluene | |||||||||||||||||||||||||
| Lead poisoning | |||||||||||||||||||||||||
| Category | Disease | Pain | Fever | N/V | Dysuria | Frequency | Urgency | Gross hematuria | BP | Edema | Other | CBC | Electrolytes | Cell | Cast | Bacteriuria | Culture | Other | Ultrasound | CT scan | Other | Gold standard for diagnosis | Associated findings | ||
- ↑ Wise, Gilbert J.; Longo, Dan L.; Schlegel, Peter N. (2015). "Sterile Pyuria". New England Journal of Medicine. 372 (11): 1048–1054. doi:10.1056/NEJMra1410052. ISSN 0028-4793.
- ↑ Stamm, Walter E. (1983). "Measurement of pyuria and its relation to bacteriuria". The American Journal of Medicine. 75 (1): 53–58. doi:10.1016/0002-9343(83)90073-6. ISSN 0002-9343.
- ↑ Groah, Suzanne; Perez-Losada, Marcos; Caldovic, Ljubica; Ljungberg, Inger; Sprague, Bruce; Castro-Nallar, Eduardo; Shah, Neel; Hsieh, Michael; Pohl, Hans (2015). "MP20-08 PYURIA AND ASYMPTOMATIC BACTERIURIA IS ASSOCIATED WITH NOVEL AND SPECIFIC URINE MICROBIOMES". The Journal of Urology. 193 (4): e226. doi:10.1016/j.juro.2015.02.980. ISSN 0022-5347.
- ↑ Shaikh, N.; Shope, T. R.; Hoberman, A.; Vigliotti, A.; Kurs-Lasky, M.; Martin, J. M. (2016). "Association Between Uropathogen and Pyuria". PEDIATRICS. 138 (1): e20160087–e20160087. doi:10.1542/peds.2016-0087. ISSN 0031-4005.