چاپ صفحه |  صفحه نخست سامانه |  نویسندگان |  اطلاعات تفضیلی |  دانلود مقاله | دانشگاه علوم پزشکی تبریز |
| نویسنده | نفر چندم مقاله |
|---|---|
| افشین قلعه گلاب بهبهانی | اول |
| عنوان | متن |
|---|---|
| کلمات کلیدی | Sterile Pyuria, UTI, Children |
| خلاصه مقاله | Introduction Pyuria has been historically defined as the presence of 10 or more white blood cells per high-power field (hpf) in a centrifuged urine specimen, but in the new era of the “enhanced urinalysis” and “automated urinalysis” methods unspun urine analysis is used of for cellular elements: more than 3 WBCs/hpf in dilute urine (USG <1.015), 6 WBCs/hpf in concentrated urine (USG ≥1.015) or a urinary dipstick test that is positive for Leukocyte Esterase. Sterile Urine is considered when there is no bacterial growth using standard aerobic culture techniques. Discussion Clinically, fever with pyuria may be considered as a urinary tract infection (UTI) that will result in empirical administration of antibiotics soon after urine sampling for microbial culture; subsequently, this may be clarified as an unreasonable mismanagement if no bacterial growth is detected on urine culture; then it will be necessary to consider differential diagnoses of sterile pyuria to make the right decision for patient: 1- Infectious: a. With true negative result of U/C: A recently treated UTI, usually within 2 weeks, partially treated bacterial UTI or even after a single dose of antibiotics; UTI with 'fastidious' or slow growing atypical organism (an organism that grows only in a specially fortified artificial culture media under specific culture conditions), genitourinary tuberculosis, STDs and atypical genitourinary infections such as Chlamydia, Mycoplasma and Ureaplasma species, Adenovirus, Schistosomiasis, vulvo-vaginitis or urethritis (infectious causes) with contamination of urine sample with vulvovaginal or urethral discharge containing leucocytes. b. With false negative result of U/C: Urine dilution by high fluid intake, Extreme frequency of urine, Use of antiseptics to clean perineum prior to collection of mid-stream urine. 2- Non-infectious: a. Systemic causes of sterile pyuria: Acute febrile illness, systemic inflammatory diseases such as SLE and Kawasaki disease, sarcoidosis, cyanotic congenital heart disease, malignant hypertension, b. Structural: Nephrocalcinosis / urolithiasis, vesicoureteral reflux, hydronephrosis, polycystic kidney disease, retained foreign body, presence of urinary catheter or recent catheterization, recent cystoscopy or urinary tract surgery, interstitial cystitis, c. Intrinsic renal or urinary tract pathology: Glomerulonephritis, papillary necrosis due to: diabetic nephropathy, sickle cell disease, obstructive uropathy; vulvo-vaginitis or urethritis (non-infectious causes), rejection of a renal transplant, pelvic irradiation, neoplasm, d. Drugs: NSAIDS, steroids, cyclophosphamide, indinavir, analgesic nephropathy (interstitial nephritis), e. Local inflammation near to urinary tract: Appendicitis, Crohn disease. |
| نام فایل | تاریخ درج فایل | اندازه فایل | دانلود |
|---|---|---|---|
| Congress of Children and Neonates Update, Tabriz, 2019.pdf | 1398/06/18 | 1328418 | دانلود |
| Certificate - Congress of Children and Neonates Update, Tabriz, 2019.pdf | 1398/06/18 | 109046 | دانلود |
