Sandbox: sadaf: Difference between revisions
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| align="center" style="background:#F5F5F5;" + | - | |||
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| align="center" style="background:#F5F5F5;" + |- | |||
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| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |Serial blood viral loads | ||
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* Increased risk in immunosuppressed kidney transplant patients | * Increased risk in immunosuppressed kidney transplant patients | ||
Revision as of 18:29, 31 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[7] | − | − | − | + | + | + | − | Nl | − | − | Nl | Nl | ↑ | − | + | + | − | − | − | Urinalysis | |||||
| Pyelonephritis[8] | + | + | + | + | + | + | − | Nl | − | − | WBC ↑ | Nl | ↑ | WBC cast | + | + | − | − | − | Clinical manifestation + urinalysis | |||||
| Viral[9] | − | − | + | + | + | + | ± | Nl | − | − | Nl | Nl | ↑ | - | - | - | - | - | - | Serial blood viral loads |
| ||||
| Tuberculosis[10][11] | + | ± | − |
|
Pulmonary TB on chest CT | Past history of pulmonary TB | |||||||||||||||||||
| 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.
- ↑ Sabih A, Leslie SW. PMID 28613784. Missing or empty
|title=(help) - ↑ Pietrucha-Dilanchian P, Hooton TM (December 2016). "Diagnosis, Treatment, and Prevention of Urinary Tract Infection". Microbiol Spectr. 4 (6). doi:10.1128/microbiolspec.UTI-0021-2015. PMID 28087935.
- ↑ Aboumohamed A, Flechner SM, Chiesa-Vottero A, Srinivas TR, Mossad SB (November 2014). "Disseminated adenoviral infection masquerading as lower urinary tract voiding dysfunction in a kidney transplant recipient". Clin. Nephrol. 82 (5): 332–6. doi:10.5414/CN107977. PMID 23816478.
- ↑ Verma AK, Mishra AK, Kumar M, Kant S, Singh A, Singh A (July 2016). "Renal tuberculosis presenting as acute pyelonephritis - A rarity". Indian J Tuberc. 63 (3): 210–213. doi:10.1016/j.ijtb.2015.07.010. PMID 27865246.
- ↑ Daher Ede F, da Silva GB, Barros EJ (January 2013). "Renal tuberculosis in the modern era". Am. J. Trop. Med. Hyg. 88 (1): 54–64. doi:10.4269/ajtmh.2013.12-0413. PMC 3541747. PMID 23303798.