• The most helpful laboratory guide for rapid diagnosis is careful microscopic examination of the urine.
• Documentation by urine culture can be helpful in diagnosing a first infection or evaluating patients with recurrent symptoms unresponsive to empirical therapy
• If hematuria is noted, the physician is obligated to be sure that it is no longer present after treatment of infection. If it is still present, a urologic imaging study and cystoscopy are necessary to rule out other urologic pathology
• If a complicated UTI is suspected by history, a similar evaluation may be necessary after the infection has cleared.
• Uncomplicated Cystitis
  • Urologic investigation in not routinely indicated
  • Diagnosis is often empiric, however, a urinalysis and/or culture can provide helpful documentation of the true diagnosis and causative organism
  • Caveats
    • Normal vaginal flora can appear to be gram-negative bacteria on urinalysis
    • Pyuria may be noted in a variety of inflammatory conditions of the urinary tract
    • If the patient is drinking increased fluids and voiding frequently, the urine will be dilute, and signs of infection on urinalysis may be missing
    • One-third of women with acute symptomatic cystitis caused by E. coli, S. saprophyticus, or Proteus have colony counts of midstream urine specimens ranging from 10² to 10⁴ cfu/mL. Thus, a pure culture in the presence of symptoms must be considered significant, regardless of colony count.

References

Please log-in or register in order to submit comments.

Powered by AkoComment!