Pyelonephritis diagnostic study of choice: Difference between revisions
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=== Study of choice === | === Study of choice === | ||
* | * [[Urine|Urinalysis]] and [[urine culture]] with susceptibility testing might confirm the diagnosis of pyelonephritis. | ||
* Pyelonephritis must be suspected if the patient has urinary symptoms including dysuria, urgency, frequency, or suprapubic pain, along with fever, chills, flank pain, pelvic or perineal pain. | * Pyelonephritis must be suspected if the patient has urinary symptoms including dysuria, urgency, frequency, or suprapubic pain, along with fever, chills, flank pain, pelvic or perineal pain. | ||
* Imaging would not be necessary for patients with pyelonephritis, unless in patients with severe and refractory illness or suspected urinary tract obstruction. | * Imaging would not be necessary for patients with pyelonephritis, unless in patients with severe and refractory illness or suspected urinary tract obstruction. | ||
==== The comparison of various diagnostic studies for | ==== The comparison of various diagnostic studies for pyelonephritis ==== | ||
{| | {| | ||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
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|- | |- | ||
! style="background: #696969; color: #FFFFFF; text-align: center;" |RBC | ! style="background: #696969; color: #FFFFFF; text-align: center;" |RBC | ||
| colspan="1" rowspan="1" style="background: #696969; color: #FFFFFF; text-align: center;" |+ | | colspan="1" rowspan="1" style="background: #696969; color: #FFFFFF; text-align: center;" | + | ||
| colspan="1" rowspan="1" style="background: #DCDCDC; padding: 5px; text-align: center;" |44% | | colspan="1" rowspan="1" style="background: #DCDCDC; padding: 5px; text-align: center;" |44% | ||
| colspan="1" rowspan="1" style="background: #DCDCDC; padding: 5px; text-align: center;" |88% | | colspan="1" rowspan="1" style="background: #DCDCDC; padding: 5px; text-align: center;" |88% | ||
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|- | |- | ||
! colspan="2" style="background: #696969; color: #FFFFFF; text-align: center;" |Urine culture | ! colspan="2" style="background: #696969; color: #FFFFFF; text-align: center;" |Urine culture | ||
| style="background: #696969; color: #FFFFFF; text-align: center;" |+ | | style="background: #696969; color: #FFFFFF; text-align: center;" | + | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |90% | | style="background: #DCDCDC; padding: 5px; text-align: center;" |90% | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" | | ||
|- | |- | ||
! colspan="2" style="background: #696969; color: #FFFFFF; text-align: center;" |Blood culture | ! colspan="2" style="background: #696969; color: #FFFFFF; text-align: center;" |Blood culture | ||
| style="background: #696969; color: #FFFFFF; text-align: center;" |+ | | style="background: #696969; color: #FFFFFF; text-align: center;" | + | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |20% | | style="background: #DCDCDC; padding: 5px; text-align: center;" |20% | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" | | ||
|} | |} | ||
==References== | ==References== |
Revision as of 19:21, 12 June 2018
Pyelonephritis Microchapters |
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Pyelonephritis diagnostic study of choice On the Web |
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Risk calculators and risk factors for Pyelonephritis diagnostic study of choice |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Diagnostic Study of Choice
Study of choice
- Urinalysis and urine culture with susceptibility testing might confirm the diagnosis of pyelonephritis.
- Pyelonephritis must be suspected if the patient has urinary symptoms including dysuria, urgency, frequency, or suprapubic pain, along with fever, chills, flank pain, pelvic or perineal pain.
- Imaging would not be necessary for patients with pyelonephritis, unless in patients with severe and refractory illness or suspected urinary tract obstruction.
The comparison of various diagnostic studies for pyelonephritis
Test | Sensitivity | Specificity | ||
---|---|---|---|---|
Urinalysis | WBC | > 5 WBCs/HPF | 72-95% | 48-82% |
> 10 WBCs/HPF | 58-82% | 65-86% | ||
RBC | + | 44% | 88% | |
Leukocyte esterase test | + | 74-96% | 94-98% | |
Nitrite test | + | 35-85% | 92-100% | |
Combination leukocyte esterase and nitrite tests | Either test + | 75-84% | 82-98% | |
Gram stain of uncentrifuged urine | > 1 bacterium per HPF | 93% | 95% | |
Urine culture | + | 90% | ||
Blood culture | + | 20% |