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Asymptomatic Bacteriuria must be differentiated from other diseases that might cause bacteriuria.<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>
Asymptomatic Bacteriuria must be differentiated from other diseases that might cause bacteriuria.<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>


'''To review differential diagnosis of pyuria, click here.'''
'''To review differential diagnosis of pyuria, click [[Pyuria#Pyuria Differential Diagnosis|here]].'''


'''To review differential diagnosis of sterile pyuria, click here.'''
'''To review differential diagnosis of sterile pyuria, click [[Sterile pyuria differential diagnosis|here]].'''
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Revision as of 16:02, 20 June 2018

Differentiating Asymptomatic Bacteriuria From Other Diseases

Asymptomatic Bacteriuria must be differentiated from other diseases that might cause bacteriuria.[1][2][3][4]

To review differential diagnosis of pyuria, click here.

To review differential diagnosis of sterile pyuria, click here.

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 Other CBC Electrolytes Urinalysis
Dysuria Frequency Urgency Gross hematuria Cell Cast Bacteriuria Culture Other
Infectious diseases UTI[5] Bacterial Asymptomatic bacteriuria[6][7] Nl Nl Nl ± + NA NA Urinalysis
  • Increased risk in pregnancy
  • Must be treated prior to an invasive urologic procedure
Cystitis[8] + + + Nl Nl Nl + + + NA Urinalysis NA
Pyelonephritis[9] + + + + + + Nl Nl + WBC cast + + NA Clinical manifestation + urinalysis NA
Prostatitis[10]  Pelvic or perineal pain + + + + + Nl or ↑
  • Dribbling of urine
  • Firm and tender prostate
Nl + ± + NA Clinical manifestation + urinalysis
  • Increased risk of bacteremia, prostatic abscess, and metastatic infection
  • Might be acute or chronic infection
Balanitis[11] Penile pain + + + + Nl
  • Pruritus
  • Erythematous lesions on the glans and/or the foreskin
Nl Nl + ± NA NA Clinical manifestation
Non−infectious diseases Urinary tract disorders Urinary catheterization[12] + + Nl Nl + + + Clinical manifestation + urinalysis
Disease Pain Fever N/V Dysuria Frequency Urgency Gross hematuria BP Other PE CBC Electrolytes Cell Cast Bacteriuria Culture Other UA findings Imaging Gold standard for diagnosis Associated findings
  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. Neal DE (February 2008). "Complicated urinary tract infections". Urol. Clin. North Am. 35 (1): 13–22, v. doi:10.1016/j.ucl.2007.09.010. PMID 18061020.
  6. Nicolle, Lindsay E. (2014). "Asymptomatic bacteriuria". Current Opinion in Infectious Diseases. 27 (1): 90–96. doi:10.1097/QCO.0000000000000019. ISSN 0951-7375.
  7. Nicolle, Lindsay E. (2015). "Asymptomatic Bacteriuria and Bacterial Interference". Microbiology Spectrum. 3 (5). doi:10.1128/microbiolspec.UTI-0001-2012. ISSN 2165-0497.
  8. Sabih A, Leslie SW. PMID 28613784. Missing or empty |title= (help)
  9. 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.
  10. Wagenlehner FM, Pilatz A, Bschleipfer T, Diemer T, Linn T, Meinhardt A, Schagdarsurengin U, Dansranjavin T, Schuppe HC, Weidner W (August 2013). "Bacterial prostatitis". World J Urol. 31 (4): 711–6. doi:10.1007/s00345-013-1055-x. PMID 23519458.
  11. Hsu CY, Lin CL, Kao CH (May 2015). "Balanitis is a risk factor for herpes zoster". Eur. J. Clin. Microbiol. Infect. Dis. 34 (5): 985–90. doi:10.1007/s10096-015-2314-0. PMID 25596845.
  12. Forster, C.S.; Haslam, D.B.; Jackson, E.; Goldstein, S.L. (2017). "Utility of a routine urinalysis in children who require clean intermittent catheterization". Journal of Pediatric Urology. 13 (5): 488.e1–488.e5. doi:10.1016/j.jpurol.2017.01.016. ISSN 1477-5131.