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! rowspan="14" align="center" style="background:#DCDCDC;" + |[[Urinary tract infection|UTI]] | ! rowspan="14" align="center" style="background:#DCDCDC;" + |[[Urinary tract infection|UTI]] | ||
! rowspan="3" align="center" style="background:#DCDCDC;" + |[[Bacteria|Bacterial]] | ! rowspan="3" align="center" style="background:#DCDCDC;" + |[[Bacteria|Bacterial]] | ||
! align="center" style="background:#DCDCDC;" + |[[Asymptomatic bacteriuria]]<ref name="Nicolle2014">{{cite journal|last1=Nicolle|first1=Lindsay E.|title=Asymptomatic bacteriuria|journal=Current Opinion in Infectious Diseases|volume=27|issue=1|year=2014|pages=90–96|issn=0951-7375|doi=10.1097/QCO.0000000000000019}}</ref> | ! align="center" style="background:#DCDCDC;" + |[[Asymptomatic bacteriuria]]<ref name="Nicolle2014">{{cite journal|last1=Nicolle|first1=Lindsay E.|title=Asymptomatic bacteriuria|journal=Current Opinion in Infectious Diseases|volume=27|issue=1|year=2014|pages=90–96|issn=0951-7375|doi=10.1097/QCO.0000000000000019}}</ref><ref name="Nicolle2015">{{cite journal|last1=Nicolle|first1=Lindsay E.|title=Asymptomatic Bacteriuria and Bacterial Interference|journal=Microbiology Spectrum|volume=3|issue=5|year=2015|issn=2165-0497|doi=10.1128/microbiolspec.UTI-0001-2012}}</ref> | ||
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Revision as of 19:51, 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[5][6] | − | − | − | − | − | − | − | 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.
- ↑ Nicolle, Lindsay E. (2014). "Asymptomatic bacteriuria". Current Opinion in Infectious Diseases. 27 (1): 90–96. doi:10.1097/QCO.0000000000000019. ISSN 0951-7375.
- ↑ Nicolle, Lindsay E. (2015). "Asymptomatic Bacteriuria and Bacterial Interference". Microbiology Spectrum. 3 (5). doi:10.1128/microbiolspec.UTI-0001-2012. ISSN 2165-0497.