Pyuria: Difference between revisions

	Pyuria
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Overview
Definition
Classification
Pyuria Differential Diagnosis
Treatment

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Latest revision as of 18:30, 24 September 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

To view a comprehensive algorithm of common findings of urine composition and urine output, click here

Overview

Pyuria is a condition in which urine contains 10 or more white cells/mm³. Gram stain and leukocyte esterase might be positive. Pyuria might be a sign of a bacterial or non bacterial urinary tract infection, genitourinary abnormalities, inflammatory disorders, and systemic diseases. Pyuria may be classified into sterile pyuria or bacteriuria. Treatment is not required for pyuria. However, underlying diseases must be treated.

Definition

Pyuria is a condition in which urine contains pus. Definition of pyuria is as follow:^[1]

Presence of 10 or more white cells/mm³ in a urine specimen
Positive result on Gram’s stain of an unspun urine specimen
Positive leukocyte esterase on urinary dipstick test

Pyuria might be a sign of a bacterial or non bacterial urinary tract infection.

Classification

Pyuria may be classified based on the presence of detectable infection as shown below:^[2]^[3]

Classification of pyuria
Group	Cell count	Bacteria	Etiology
Sterile pyuria	↑	-	Might have infectious or non-infectious etiologies.
Bacteriuria	↑	Positive bacterial colony >1000 colony-forming units/ml	Mostly have infectious etiologies.

Pyuria Differential Diagnosis

Differentiating the diseases that can cause pyuria:^[4]^[5]^[6]^[7]

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		Para−clinical findings
				Symptoms							Physical examination		Lab Findings							Imaging
				Pain	Fever	N/V	Urinary symptoms				BP	Other	CBC	Electrolytes	Urinalysis
				Pain	Fever	N/V	Dysuria	Frequency	Urgency	Gross hematuria	BP	Other	CBC	Electrolytes	Cell	Cast	Bacteriuria	Culture	Other
Infectious diseases	UTI^[8]	Bacterial	Asymptomatic bacteriuria^[9]^[10]	−	−	−	−	−	−	−	Nl	−	Nl	Nl	±	−	+	−	NA	NA	Urinalysis	Increased risk in pregnancy Must be treated prior to an invasive urologic procedure
			Cystitis^[11]	−	−	−	+	+	+	−	Nl	−	Nl	Nl	+	−	+	+	Nitrite + Leukocyte esterase +	NA	Urinalysis	NA
			Pyelonephritis^[12]	+	+	+	+	+	+	−	Nl	−	Leukocytosis	Nl	+	WBC cast	+	+	Nitrite + Leukocyte esterase +	NA	Clinical manifestation + urinalysis	NA
		Viral^[13]^[14]		−	−	+	+	+	+	±	Nl	−	Nl	Nl	+	−	−	−	NA	NA	PCR viral load	Increased risk in immunosuppressed kidney transplant patients CMV, EBV, BK virus, adenovirus might be seen
		Tuberculosis^[15]^[16]^[17]^[18]		−	±	−	+	+	+	+	Nl	−	Nl	Nl	±	−	−	Positive mycobacterial urine culture	Microscopic hematuria	Pulmonary TB on chest CT	Urine mycobacterial PCR	Past history of pulmonary TB
		Fungal^[19]^[20]		−	−	−	+	+	−	−	Nl	−	Nl	Nl	±	−	−	+ after several weeks of follow up	NA	Hydronephrosis on ultrasound	Urine culture	Increased risk in patients with long−term foley catheters Candida as the most prevalent fungus
		STD	Chlamydia^[21]^[22]	Chronic pelvic pain	−	−	+	+	−	−	Nl	Abdominal tenderness Adnexal motion tenderness	Nl	Nl	+	−	−	+	NA	NA	PCR	Females might have concurrent chlamydial cervicitis Must be considered in young, sexually active males
			Gonococcus^[23]^[24]^[25]	Chronic pelvic pain	−	−	+	+	−	−	Nl	Abdominal tenderness Adnexal motion tenderness	Nl	Nl	+	−	−	+ High false negative result	Intracellular gram−negative diplococci on gram stain	NA	Nucleic acid amplification testing (NAAT)	Females might have concurrent cervical gonococcal infection Must be considered in young, sexually active males
			Ureaplasma urealyticum^[26]	−	−	−	+	+	−	−	Nl	−	Nl	Nl	+	−	−	−	Gram stain −	NA	PCR	Associated with complications of pregnancy
			Herpes simplex virus^[27]	+	+	−	+	+	−	−	Nl	Painful genital ulcers Tender local inguinal lymphadenopathy Acute urinary retention Loss of sacral sensation	Nl	Nl	+	−	−	Viral culture +	NA	NA	Clinical manifestation + PCR	Associated with extragenital complications, like aseptic meningitis High risk of recurrence
			Herpes zoster^[28]	−	−	−	+	+	−	−	Nl	Rash Acute neuritis	Nl	Nl	+	−	−	−	Microscopic hematuria	NA	Clinical manifestation + PCR	Associated with lumbosacral dermatome involvement
			HPV^[29]	−	−	−	+	−	−	−	Nl	Genital wart Cancerous lesions of the genitalia	Nl	Nl	+	−	−	−	NA	NA	Clinical manifestation + PCR	Associated with bladder carcinoma Prevented by HPV vaccination
			HIV^[30]	−	+	+	+	+	−	−	Nl	Painful mucocutaneous ulceration Lymphadenopathy Aseptic meningitis Diarrhea Weight loss	Leukopenia	Nl	+	−	−	−	NA	NA	Combination antigen/antibody immunoassay + PCR HIV viral load test	Might be gone to chronic HIV infection with or without evidence of the acquired immunodeficiency syndrome (AIDS) Associated with acute interstitial nephritis
		Prostatitis^[31]		Pelvic or perineal pain	+	+	+	+	+	−	Nl or ↑	Dribbling of urine Firm and tender prostate	Leukocytosis	Nl	+	−	±	+	Cloudy urine Positive gram stain	NA	Clinical manifestation + urinalysis	Increased risk of bacteremia, prostatic abscess, and metastatic infection Might be acute or chronic infection
	Balanitis^[32]			Penile pain	+	−	+	+	+	−	Nl	Pruritus Erythematous lesions on the glans and/or the foreskin	Nl	Nl	+	−	±	−	NA	NA	Clinical manifestation	Associated with reactive arthritis
	Appendicitis^[33]^[34]			Right lower abdominal pain	+	+	+	+	+	−	Nl	Right lower abdominal tenderness	Leukocytosis	Nl	+	−	−	−	Urine specific gravity >1.020	Enlarged appendiceal diameter on CT scan or ultrasound	Clinical manifestation	NA
Category	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
Non−infectious diseases	Urinary tract disorders	Urinary catheterization^[35]		−	−	−	+	+	−	−	Nl	−	Leukocytosis ±	Nl	+	−	+	+	Leukocyte esterase ±	−	Clinical manifestation + urinalysis	Predicting UTI in children who required clean intermittent catheterization by routine urinalysis
		Urinary tract stone^[36]^[37]		Colicky pain	−	+	+	+	+	±	Nl	−	Nl	Nl	+	−	−	−	Microscopic hematuria	Visible stone on CT scan	Clinical manifestation	Might cause renal obstruction
		Urinary tract neoplasm^[38]		+	+	+	+	+	+	+	Nl	−	Nl	Nl	+	−	−	−	Microscopic hematuria	Visible tumor on CT scan	Cystoscopy + biopsy	Associated with non−muscle−invasive bladder cancer (NMIBC)
		Urinary fistula^[39]		−	−	−	+	+	−	−	Nl	Urinary incontinence	Nl	Nl	+	−	−	−	NA	Fistula on cystoscopy or IVP	Physical examination	History of recent surgery
		Interstitial cystitis^[40]		Chronic bladder pain	−	−	+	+	+	−	Nl	Abdominal tenderness	Nl	Nl	+	−	−	−	NA	NA	Clinical manifestation	Associated with other chronic pain syndromes
		Vesicoureteral reflux^[41]		+	−	−	+	−	−	−	Nl	Oliguria	Nl	Nl	+	−	−	−			Imaging
		Hydronephrosis^[42]		−	−	−	+	−	−	−	Nl	Oliguria	Nl	Nl	+	−	−	−			Imaging
	Renal diseases	Polycystic kidney disease^[43]		Flank or back pain	−	−	+	+	−	+	↑	Polyuria Nocturia	Nl	Nl	+	−	−	−	Hypocitraturia Hyperuricemia Hyperoxaluria Low urine pH Microscopic hematuria Proteinuria <1 g/day	Multiple cysts on ultrasound	Imaging
		Renal vein thrombosis^[44]		Flank pain	+	+	+	+	+	+	Nl or ↑	Might be asymptomatic Signs of acute renal failure	Leukocytosis	Hyperkalemia	+	−	−	−	Proteinuria Microscopic hematuria	Thrombosis on CT scan	Renal venography	Increased risk in nephrotic syndrome and hypercoagulable state
		Interstitial nephritis^[45]		Lower back pain	−	−	+	+	−	−	Nl or ↑	Rash Weight loss Oliguria	Eosinophilia	Hyperkalemia Isosthenuria	+	+	−	−	Proteinuria Eosinophiluria	Nl	Clinical manifestation + urinalysis	Associated with medications, particularly antibiotics
		IgA nephropathy^[46]		−	−	−	−	−	−	+	Nl or ↑	Might be asymptomatic	Nl	Nl	+	−	−	−	Proteinuria Microscopic hematuria	Nl	Biopsy	History of upper respiratory infection
		Renal transplant rejection^[47]		Flank pain	+	+	+	+	+	+	↑	Might be asymptomatic Oliguria	Leukocytosis	Nl	+	+	−	−	Proteinuria Microscopic hematuria	Increased graft size on ultrasound	Renal allograft biopsy	Acute rise in the serum creatinine History of transplant
	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
	Systemic disease	Diabetic nephropathy^[48]		−	−	−	−	−	−	±	↑	Might be asymptomatic	Nl	Nl	+	−	−	−	Albuminuria Microscopic hematuria	Nl	Clinical manifestation + laboratory tests	History of retinopathy and neuropathy Slow and progressive renal failure
		Lupus nephritis^[49]		−	+	−	+	+	+	+	↑	Rash Oral ulcer Arthritis	Pancytopenia	Nl	+	+	−	−	Hematuria Proteinuria	Enlarged kidneys on CT scan	Biopsy	Abnormal results of specific serologic tests
		Sjögren’s syndrome^[50]		−	−	−	+	+	−	−	↑	Dryness of all mucous membranes	Pancytopenia	Nl	+	+	−	−	Hematuria Proteinuria	Abnormal diffuse fat tissue deposition and diffuse punctate calcification on parotid gland CT scan	Clinical manifestation + laboratory tests	Abnormal results of specific serologic tests
		Kawasaki's disease^[51]		−	+	−	+	+	+	−	Nl	Rash Irritability Desquamation of skin and mucous membranes	Normocytic normochromic anemia Thrombocytosis Leukocytosis	Hyponatremia	+	−	−	−	−	Vessels involvement on angiography	Clinical manifestation	Associated with multiple organ involvement including heart
	Medication/toxin	Analgesic nephropathy^[52]		Flank pain	+	+	+	+	+	+	↑	Chronic headache Low back pain	Eosinophilia	Hyperkalemia Isosthenuria	+	+	−	−	Proteinuria Eosinophiluria	Renal impairment on CT scan	Imaging	Characterized by papillary necrosis and chronic interstitial nephritis Caused by the chronic use of analgesic agents
	Medication/toxin	Contrast−induced nephropathy^[53]		+	−	+	+	−	−	−	Nl	Oliguria	Nl	Hyperkalemia Acidosis Hyperphosphatemia	+	+	−	−	Fractional sodium excretion (FENa) <1%	NA	Clinical manifestation + exclusion of other causes of AKI	Associated with reversible type of acute kidney injury Acute increase in the serum creatinine
Category	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

Treatment

Sterile pyuria

Pathogen-directed antimicrobial therapy^[54]

Renal Tuberculosis

Preferred regimen: (Isoniazid 300 mg PO qd for 2 months AND Rifampicin 450-600 mg qd for 2 months AND Ethambutol 15-25 mg/kg PO qd for 2 months AND Pyrazinamide 1500 mg for 2 months) THEN (Isoniazid 300 mg PO qd for 4-6 months AND Rifampicin 450-600 mg qd for 4-6 months)

Gonorrhea

Preferred regimen: Ceftriaxone 250 mg IM in a single dose THEN (Azithromycin 1 g PO in a single dose OR Doxycycline 100 mg PO bid for 7 days)

Chlamydia

Preferred regimen: Azithromycin 1 g PO in single dose OR Doxycycline 100 mg PO bid for 7 days
Alternative regimen: Erythromycin base 500 mg PO qid for 7 days

Mycoplasma and Ureaplasma

Preferred regimen: Azithromycin OR Levofloxacin OR Moxifloxacin

Genital herpes

Preferred regimen: Acyclovir 400 mg PO tid for 7–10 days or Acyclovir 200 mg PO five times a day for 7–10 days OR Famciclovir 250 mg PO tid for 7–10 days OR Valacyclovir 1 g PO bid for 7 days

Trichomoniasis

Preferred regimen: Metronidazole 2 g PO in a single dose OR Tinidazole 2 g PO in a single dose

Note: Treat patient’s sex partner if trichomoniasis is diagnosed in patient.

Fungal infections^[55]

Preferred regimen, Candida albicans: Fluconazole 100 mg PO qd for 2-5 days
Preferred regimen, non-albicans Candida: Amphotericin B 0.1 mg/kg/day IV for 2-5 days OR Amphotericin B bladder irrigation 5-50 mg/L of sterile water qd for 2-5 days

Schistosomiasis

Preferred regimen: Praziquantel 20 mg/kg PO bid for 1–2 days

References

↑ Horan, Teresa C.; Andrus, Mary; Dudeck, Margaret A. (2008-06). "CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting". American Journal of Infection Control. 36 (5): 309–332. doi:10.1016/j.ajic.2008.03.002. ISSN 1527-3296. PMID 18538699. Check date values in: |date= (help)
↑ Wise, Gilbert J.; Schlegel, Peter N. (2015-03-12). "Sterile pyuria". The New England Journal of Medicine. 372 (11): 1048–1054. doi:10.1056/NEJMra1410052. ISSN 1533-4406. PMID 25760357.
↑ Kwon, Jennie H.; Fausone, Maureen K.; Du, Hongyan; Robicsek, Ari; Peterson, Lance R. (2012-05). "Impact of laboratory-reported urine culture colony counts on the diagnosis and treatment of urinary tract infection for hospitalized patients". American Journal of Clinical Pathology. 137 (5): 778–784. doi:10.1309/AJCP4KVGQZEG1YDM. ISSN 1943-7722. PMID 22523217. Check date values in: |date= (help)
↑ 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.
↑ 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.
↑ 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.
↑ Santiago-Rodriguez TM, Ly M, Bonilla N, Pride DT (2015). "The human urine virome in association with urinary tract infections". Front Microbiol. 6: 14. doi:10.3389/fmicb.2015.00014. PMC 4304238. PMID 25667584.
↑ Altiparmak MR, Trabulus S, Balkan II, Yalin SF, Denizli N, Aslan G, Doruk HE, Engin A, Tekin R, Birengel S, Cetin BD, Arslan F, Turhan V, Mert A (August 2015). "Urinary tuberculosis: a cohort of 79 adult cases". Ren Fail. 37 (7): 1157–63. doi:10.3109/0886022X.2015.1057460. PMID 26123266.
↑ 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.
↑ Czapka M, Shukla S, Slosar-Cheah M (August 2017). "Urine trouble: genitourinary tuberculosis and subsequent DRESS syndrome". BMJ Case Rep. 2017. doi:10.1136/bcr-2017-220440. PMID 28784884.
↑ Kim J, Kim DS, Lee YS, Choi NG (September 2011). "Fungal urinary tract infection in burn patients with long-term foley catheterization". Korean J Urol. 52 (9): 626–31. doi:10.4111/kju.2011.52.9.626. PMC 3198237. PMID 22025959.
↑ Carvalho M, Guimarães CM, Mayer JR, Bordignon GP, Queiroz-Telles F (December 2001). "Hospital-associated funguria: analysis of risk factors, clinical presentation and outcome". Braz J Infect Dis. 5 (6): 313–8. PMID 11980593.
↑ Matthews, R.S.; Bonigal, S.D.; Wise, R. (1990). "Sterile pyuria and Chlamydia trachomatis". The Lancet. 336 (8711): 385. doi:10.1016/0140-6736(90)91936-5. ISSN 0140-6736.
↑ Tayal SC, Pattman RS (1996). "Sterile pyuria: consider chlamydial infection". Br J Clin Pract. 50 (3): 166–7. PMID 8733337.
↑ Clarke M, Maskell R (December 1981). "Gonorrhoea presenting as "sterile" pyuria". Br Med J (Clin Res Ed). 283 (6305): 1546. PMC 1507898. PMID 6799059.
↑ Jephcott AE (August 1997). "Microbiological diagnosis of gonorrhoea". Genitourin Med. 73 (4): 245–52. PMC 1195851. PMID 9389943.
↑ Tomas ME, Getman D, Donskey CJ, Hecker MT (August 2015). "Overdiagnosis of Urinary Tract Infection and Underdiagnosis of Sexually Transmitted Infection in Adult Women Presenting to an Emergency Department". J. Clin. Microbiol. 53 (8): 2686–92. doi:10.1128/JCM.00670-15. PMC 4508438. PMID 26063863.
↑ Nassar FA, Abu-Elamreen FH, Shubair ME, Sharif FA (2008). "Detection of Chlamydia trachomatis and Mycoplasma hominis, genitalium and Ureaplasma urealyticum by polymerase chain reaction in patients with sterile pyuria". Adv Med Sci. 53 (1): 80–6. doi:10.2478/v10039-008-0020-1. PMID 18614434.
↑ Xu F, Sternberg MR, Kottiri BJ, McQuillan GM, Lee FK, Nahmias AJ, Berman SM, Markowitz LE (August 2006). "Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States". JAMA. 296 (8): 964–73. doi:10.1001/jama.296.8.964. PMID 16926356.
↑ Chen, Po-Hong; Hsueh, Hsiu-Fang; Hong, Chang-Zern (2002). "Herpes zoster–associated voiding dysfunction: A retrospective study and literature review". Archives of Physical Medicine and Rehabilitation. 83 (11): 1624–1628. doi:10.1053/apmr.2002.34602. ISSN 0003-9993.
↑ Guo CC, Fine SW, Epstein JI (July 2006). "Noninvasive squamous lesions in the urinary bladder: a clinicopathologic analysis of 29 cases". Am. J. Surg. Pathol. 30 (7): 883–91. doi:10.1097/01.pas.0000213283.20166.5a. PMID 16819332.
↑ Parkhie SM, Fine DM, Lucas GM, Atta MG (May 2010). "Characteristics of patients with HIV and biopsy-proven acute interstitial nephritis". Clin J Am Soc Nephrol. 5 (5): 798–804. doi:10.2215/CJN.08211109. PMC 2863972. PMID 20338962.
↑ 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.
↑ 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.
↑ Lee SL, Walsh AJ, Ho HS (May 2001). "Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis". Arch Surg. 136 (5): 556–62. PMID 11343547.
↑ Mahattanobon S, Samphao S, Pruekprasert P (August 2014). "Clinical features of complicated acute appendicitis". J Med Assoc Thai. 97 (8): 835–40. PMID 25345259.
↑ 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.
↑ Fwu CW, Eggers PW, Kimmel PL, Kusek JW, Kirkali Z (March 2013). "Emergency department visits, use of imaging, and drugs for urolithiasis have increased in the United States". Kidney Int. 83 (3): 479–86. doi:10.1038/ki.2012.419. PMC 3587650. PMID 23283137.
↑ Singh P, Enders FT, Vaughan LE, Bergstralh EJ, Knoedler JJ, Krambeck AE, Lieske JC, Rule AD (October 2015). "Stone Composition Among First-Time Symptomatic Kidney Stone Formers in the Community". Mayo Clin. Proc. 90 (10): 1356–65. doi:10.1016/j.mayocp.2015.07.016. PMC 4593754. PMID 26349951.
↑ Azuma T, Nagase Y, Oshi M (September 2013). "Pyuria predicts poor prognosis in patients with non-muscle-invasive bladder cancer". Clin Genitourin Cancer. 11 (3): 331–6. doi:10.1016/j.clgc.2013.04.002. PMID 23664207.
↑ Hampton BS, Kay A, Pilzek A (January 2015). "Urinary fistula and incontinence". Semin. Reprod. Med. 33 (1): 47–52. doi:10.1055/s-0034-1395279. PMID 25565512.
↑ Konkle KS, Berry SH, Elliott MN, Hilton L, Suttorp MJ, Clauw DJ, Clemens JQ (February 2012). "Comparison of an interstitial cystitis/bladder pain syndrome clinical cohort with symptomatic community women from the RAND Interstitial Cystitis Epidemiology study". J. Urol. 187 (2): 508–12. doi:10.1016/j.juro.2011.10.040. PMC 3894739. PMID 22177158.
↑ Hubert KC, Kokorowski PJ, Huang L, Prasad MM, Rosoklija I, Retik AB, Nelson CP (February 2014). "New contralateral vesicoureteral reflux after unilateral ureteral reimplantation: predictive factors and clinical outcomes". J. Urol. 191 (2): 451–7. doi:10.1016/j.juro.2013.08.076. PMC 4123205. PMID 24012582.
↑ Dancz CE, Walker D, Thomas D, Özel B (August 2015). "Prevalence of Hydronephrosis in Women With Advanced Pelvic Organ Prolapse". Urology. 86 (2): 250–4. doi:10.1016/j.urology.2015.05.005. PMID 26194290.
↑ Paul BM, Vanden Heuvel GB (2014). "Kidney: polycystic kidney disease". Wiley Interdiscip Rev Dev Biol. 3 (6): 465–87. doi:10.1002/wdev.152. PMC 4423807. PMID 25186187.
↑ Mahmoodi BK, ten Kate MK, Waanders F, Veeger NJ, Brouwer JL, Vogt L, Navis G, van der Meer J (January 2008). "High absolute risks and predictors of venous and arterial thromboembolic events in patients with nephrotic syndrome: results from a large retrospective cohort study". Circulation. 117 (2): 224–30. doi:10.1161/CIRCULATIONAHA.107.716951. PMID 18158362.
↑ Raghavan R, Eknoyan G (September 2014). "Acute interstitial nephritis - a reappraisal and update". Clin. Nephrol. 82 (3): 149–62. PMC 4928030. PMID 25079860.
↑ Roberts IS (August 2014). "Pathology of IgA nephropathy". Nat Rev Nephrol. 10 (8): 445–54. doi:10.1038/nrneph.2014.92. PMID 24861083.
↑ Martin-Moreno PL, Tripathi S, Chandraker A (May 2018). "Regulatory T Cells and Kidney Transplantation". Clin J Am Soc Nephrol. doi:10.2215/CJN.01750218. PMID 29789350.
↑ Bjornstad P, Cherney D, Maahs DM (August 2014). "Early diabetic nephropathy in type 1 diabetes: new insights". Curr Opin Endocrinol Diabetes Obes. 21 (4): 279–86. doi:10.1097/MED.0000000000000074. PMC 4138314. PMID 24983394.
↑ Schwartz, Noa; Goilav, Beatrice; Putterman, Chaim (2014). "The pathogenesis, diagnosis and treatment of lupus nephritis". Current Opinion in Rheumatology. 26 (5): 502–509. doi:10.1097/BOR.0000000000000089. ISSN 1040-8711.
↑ de Paiva, Cintia S.; Rocha, Eduardo Melani (2015). "Sjögren syndrome". Current Opinion in Ophthalmology. 26 (6): 517–525. doi:10.1097/ICU.0000000000000208. ISSN 1040-8738.
↑ Wirojanan J, Sopontammarak S, Vachvanichsanong P (March 2004). "Sterile pyuria in Kawasaki disease". Pediatr. Nephrol. 19 (3): 363. doi:10.1007/s00467-003-1394-8. PMID 14745638.
↑ Henderickx M, Brits T, De Baets K, Seghers M, Maes P, Trouet D, De Wachter S, De Win G (June 2017). "Renal papillary necrosis in patients with sickle cell disease: How to recognize this 'forgotten' diagnosis". J Pediatr Urol. 13 (3): 250–256. doi:10.1016/j.jpurol.2017.01.020. PMID 28341428. Vancouver style error: initials (help)
↑ Patschan, D.; Buschmann, I.; Ritter, O. (2018). "Contrast-Induced Nephropathy: Update on the Use of Crystalloids and Pharmacological Measures". International Journal of Nephrology. 2018: 1–8. doi:10.1155/2018/5727309. ISSN 2090-214X.
↑ Wise, Gilbert J.; Schlegel, Peter N. (2015-03-12). "Sterile pyuria". The New England Journal of Medicine. 372 (11): 1048–1054. doi:10.1056/NEJMra1410052. ISSN 1533-4406. PMID 25760357.
↑ Jacobs LG, Skidmore EA, Freeman K, Lipschultz D, Fox N (1996). "Oral fluconazole compared with bladder irrigation with amphotericin B for treatment of fungal urinary tract infections in elderly patients". Clin Infect Dis. 22 (1): 30–5. PMID 8824962.

Template:WH Template:WS

[1] Horan, Teresa C.; Andrus, Mary; Dudeck, Margaret A. (2008-06). "CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting". American Journal of Infection Control. 36 (5): 309–332. doi:10.1016/j.ajic.2008.03.002. ISSN 1527-3296. PMID 18538699. Check date values in: |date= (help)

[2] Wise, Gilbert J.; Schlegel, Peter N. (2015-03-12). "Sterile pyuria". The New England Journal of Medicine. 372 (11): 1048–1054. doi:10.1056/NEJMra1410052. ISSN 1533-4406. PMID 25760357.

[3] Kwon, Jennie H.; Fausone, Maureen K.; Du, Hongyan; Robicsek, Ari; Peterson, Lance R. (2012-05). "Impact of laboratory-reported urine culture colony counts on the diagnosis and treatment of urinary tract infection for hospitalized patients". American Journal of Clinical Pathology. 137 (5): 778–784. doi:10.1309/AJCP4KVGQZEG1YDM. ISSN 1943-7722. PMID 22523217. Check date values in: |date= (help)

[WiseLongo2015-4] 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.

[Stamm1983-5] 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.

[GroahPerez-Losada2015-6] 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.

[ShaikhShope2016-7] 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.

[pmid18061020-8] 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.

[Nicolle2014-9] Nicolle, Lindsay E. (2014). "Asymptomatic bacteriuria". Current Opinion in Infectious Diseases. 27 (1): 90–96. doi:10.1097/QCO.0000000000000019. ISSN 0951-7375.

[Nicolle2015-10] Nicolle, Lindsay E. (2015). "Asymptomatic Bacteriuria and Bacterial Interference". Microbiology Spectrum. 3 (5). doi:10.1128/microbiolspec.UTI-0001-2012. ISSN 2165-0497.

[pmid28613784-11] Sabih A, Leslie SW. PMID 28613784. Missing or empty |title= (help)

[pmid28087935-12] 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.

[pmid23816478-13] 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.

[pmid25667584-14] Santiago-Rodriguez TM, Ly M, Bonilla N, Pride DT (2015). "The human urine virome in association with urinary tract infections". Front Microbiol. 6: 14. doi:10.3389/fmicb.2015.00014. PMC 4304238. PMID 25667584.

[pmid26123266-15] Altiparmak MR, Trabulus S, Balkan II, Yalin SF, Denizli N, Aslan G, Doruk HE, Engin A, Tekin R, Birengel S, Cetin BD, Arslan F, Turhan V, Mert A (August 2015). "Urinary tuberculosis: a cohort of 79 adult cases". Ren Fail. 37 (7): 1157–63. doi:10.3109/0886022X.2015.1057460. PMID 26123266.

[pmid27865246-16] 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.

[pmid23303798-17] 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.

[pmid28784884-18] Czapka M, Shukla S, Slosar-Cheah M (August 2017). "Urine trouble: genitourinary tuberculosis and subsequent DRESS syndrome". BMJ Case Rep. 2017. doi:10.1136/bcr-2017-220440. PMID 28784884.

[pmid22025959-19] Kim J, Kim DS, Lee YS, Choi NG (September 2011). "Fungal urinary tract infection in burn patients with long-term foley catheterization". Korean J Urol. 52 (9): 626–31. doi:10.4111/kju.2011.52.9.626. PMC 3198237. PMID 22025959.

[pmid11980593-20] Carvalho M, Guimarães CM, Mayer JR, Bordignon GP, Queiroz-Telles F (December 2001). "Hospital-associated funguria: analysis of risk factors, clinical presentation and outcome". Braz J Infect Dis. 5 (6): 313–8. PMID 11980593.

[MatthewsBonigal1990-21] Matthews, R.S.; Bonigal, S.D.; Wise, R. (1990). "Sterile pyuria and Chlamydia trachomatis". The Lancet. 336 (8711): 385. doi:10.1016/0140-6736(90)91936-5. ISSN 0140-6736.

[pmid8733337-22] Tayal SC, Pattman RS (1996). "Sterile pyuria: consider chlamydial infection". Br J Clin Pract. 50 (3): 166–7. PMID 8733337.

[pmid6799059-23] Clarke M, Maskell R (December 1981). "Gonorrhoea presenting as "sterile" pyuria". Br Med J (Clin Res Ed). 283 (6305): 1546. PMC 1507898. PMID 6799059.

[pmid9389943-24] Jephcott AE (August 1997). "Microbiological diagnosis of gonorrhoea". Genitourin Med. 73 (4): 245–52. PMC 1195851. PMID 9389943.

[pmid26063863-25] Tomas ME, Getman D, Donskey CJ, Hecker MT (August 2015). "Overdiagnosis of Urinary Tract Infection and Underdiagnosis of Sexually Transmitted Infection in Adult Women Presenting to an Emergency Department". J. Clin. Microbiol. 53 (8): 2686–92. doi:10.1128/JCM.00670-15. PMC 4508438. PMID 26063863.

[pmid18614434-26] Nassar FA, Abu-Elamreen FH, Shubair ME, Sharif FA (2008). "Detection of Chlamydia trachomatis and Mycoplasma hominis, genitalium and Ureaplasma urealyticum by polymerase chain reaction in patients with sterile pyuria". Adv Med Sci. 53 (1): 80–6. doi:10.2478/v10039-008-0020-1. PMID 18614434.

[pmid16926356-27] Xu F, Sternberg MR, Kottiri BJ, McQuillan GM, Lee FK, Nahmias AJ, Berman SM, Markowitz LE (August 2006). "Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States". JAMA. 296 (8): 964–73. doi:10.1001/jama.296.8.964. PMID 16926356.

[ChenHsueh2002-28] Chen, Po-Hong; Hsueh, Hsiu-Fang; Hong, Chang-Zern (2002). "Herpes zoster–associated voiding dysfunction: A retrospective study and literature review". Archives of Physical Medicine and Rehabilitation. 83 (11): 1624–1628. doi:10.1053/apmr.2002.34602. ISSN 0003-9993.

[pmid16819332-29] Guo CC, Fine SW, Epstein JI (July 2006). "Noninvasive squamous lesions in the urinary bladder: a clinicopathologic analysis of 29 cases". Am. J. Surg. Pathol. 30 (7): 883–91. doi:10.1097/01.pas.0000213283.20166.5a. PMID 16819332.

[pmid20338962-30] Parkhie SM, Fine DM, Lucas GM, Atta MG (May 2010). "Characteristics of patients with HIV and biopsy-proven acute interstitial nephritis". Clin J Am Soc Nephrol. 5 (5): 798–804. doi:10.2215/CJN.08211109. PMC 2863972. PMID 20338962.

[pmid23519458-31] 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.

[pmid25596845-32] 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.

[pmid11343547-33] Lee SL, Walsh AJ, Ho HS (May 2001). "Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis". Arch Surg. 136 (5): 556–62. PMID 11343547.

[pmid25345259-34] Mahattanobon S, Samphao S, Pruekprasert P (August 2014). "Clinical features of complicated acute appendicitis". J Med Assoc Thai. 97 (8): 835–40. PMID 25345259.

[ForsterHaslam2017-35] 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.

[pmid23283137-36] Fwu CW, Eggers PW, Kimmel PL, Kusek JW, Kirkali Z (March 2013). "Emergency department visits, use of imaging, and drugs for urolithiasis have increased in the United States". Kidney Int. 83 (3): 479–86. doi:10.1038/ki.2012.419. PMC 3587650. PMID 23283137.

[pmid26349951-37] Singh P, Enders FT, Vaughan LE, Bergstralh EJ, Knoedler JJ, Krambeck AE, Lieske JC, Rule AD (October 2015). "Stone Composition Among First-Time Symptomatic Kidney Stone Formers in the Community". Mayo Clin. Proc. 90 (10): 1356–65. doi:10.1016/j.mayocp.2015.07.016. PMC 4593754. PMID 26349951.

[pmid23664207-38] Azuma T, Nagase Y, Oshi M (September 2013). "Pyuria predicts poor prognosis in patients with non-muscle-invasive bladder cancer". Clin Genitourin Cancer. 11 (3): 331–6. doi:10.1016/j.clgc.2013.04.002. PMID 23664207.

[pmid25565512-39] Hampton BS, Kay A, Pilzek A (January 2015). "Urinary fistula and incontinence". Semin. Reprod. Med. 33 (1): 47–52. doi:10.1055/s-0034-1395279. PMID 25565512.

[pmid22177158-40] Konkle KS, Berry SH, Elliott MN, Hilton L, Suttorp MJ, Clauw DJ, Clemens JQ (February 2012). "Comparison of an interstitial cystitis/bladder pain syndrome clinical cohort with symptomatic community women from the RAND Interstitial Cystitis Epidemiology study". J. Urol. 187 (2): 508–12. doi:10.1016/j.juro.2011.10.040. PMC 3894739. PMID 22177158.

[pmid24012582-41] Hubert KC, Kokorowski PJ, Huang L, Prasad MM, Rosoklija I, Retik AB, Nelson CP (February 2014). "New contralateral vesicoureteral reflux after unilateral ureteral reimplantation: predictive factors and clinical outcomes". J. Urol. 191 (2): 451–7. doi:10.1016/j.juro.2013.08.076. PMC 4123205. PMID 24012582.

[pmid26194290-42] Dancz CE, Walker D, Thomas D, Özel B (August 2015). "Prevalence of Hydronephrosis in Women With Advanced Pelvic Organ Prolapse". Urology. 86 (2): 250–4. doi:10.1016/j.urology.2015.05.005. PMID 26194290.

[pmid25186187-43] Paul BM, Vanden Heuvel GB (2014). "Kidney: polycystic kidney disease". Wiley Interdiscip Rev Dev Biol. 3 (6): 465–87. doi:10.1002/wdev.152. PMC 4423807. PMID 25186187.

[pmid18158362-44] Mahmoodi BK, ten Kate MK, Waanders F, Veeger NJ, Brouwer JL, Vogt L, Navis G, van der Meer J (January 2008). "High absolute risks and predictors of venous and arterial thromboembolic events in patients with nephrotic syndrome: results from a large retrospective cohort study". Circulation. 117 (2): 224–30. doi:10.1161/CIRCULATIONAHA.107.716951. PMID 18158362.

[pmid25079860-45] Raghavan R, Eknoyan G (September 2014). "Acute interstitial nephritis - a reappraisal and update". Clin. Nephrol. 82 (3): 149–62. PMC 4928030. PMID 25079860.

[pmid24861083-46] Roberts IS (August 2014). "Pathology of IgA nephropathy". Nat Rev Nephrol. 10 (8): 445–54. doi:10.1038/nrneph.2014.92. PMID 24861083.

[pmid29789350-47] Martin-Moreno PL, Tripathi S, Chandraker A (May 2018). "Regulatory T Cells and Kidney Transplantation". Clin J Am Soc Nephrol. doi:10.2215/CJN.01750218. PMID 29789350.

[pmid24983394-48] Bjornstad P, Cherney D, Maahs DM (August 2014). "Early diabetic nephropathy in type 1 diabetes: new insights". Curr Opin Endocrinol Diabetes Obes. 21 (4): 279–86. doi:10.1097/MED.0000000000000074. PMC 4138314. PMID 24983394.

[SchwartzGoilav2014-49] Schwartz, Noa; Goilav, Beatrice; Putterman, Chaim (2014). "The pathogenesis, diagnosis and treatment of lupus nephritis". Current Opinion in Rheumatology. 26 (5): 502–509. doi:10.1097/BOR.0000000000000089. ISSN 1040-8711.

[de_PaivaRocha2015-50] Paiva, Cintia S.; Rocha, Eduardo Melani (2015). "Sjögren syndrome". Current Opinion in Ophthalmology. 26 (6): 517–525. doi:10.1097/ICU.0000000000000208. ISSN 1040-8738.

[pmid14745638-51] Wirojanan J, Sopontammarak S, Vachvanichsanong P (March 2004). "Sterile pyuria in Kawasaki disease". Pediatr. Nephrol. 19 (3): 363. doi:10.1007/s00467-003-1394-8. PMID 14745638.

[pmid28341428-52] Henderickx M, Brits T, De Baets K, Seghers M, Maes P, Trouet D, De Wachter S, De Win G (June 2017). "Renal papillary necrosis in patients with sickle cell disease: How to recognize this 'forgotten' diagnosis". J Pediatr Urol. 13 (3): 250–256. doi:10.1016/j.jpurol.2017.01.020. PMID 28341428. Vancouver style error: initials (help)

[PatschanBuschmann2018-53] Patschan, D.; Buschmann, I.; Ritter, O. (2018). "Contrast-Induced Nephropathy: Update on the Use of Crystalloids and Pharmacological Measures". International Journal of Nephrology. 2018: 1–8. doi:10.1155/2018/5727309. ISSN 2090-214X.

[54] Wise, Gilbert J.; Schlegel, Peter N. (2015-03-12). "Sterile pyuria". The New England Journal of Medicine. 372 (11): 1048–1054. doi:10.1056/NEJMra1410052. ISSN 1533-4406. PMID 25760357.

[pmid8824962-55] Jacobs LG, Skidmore EA, Freeman K, Lipschultz D, Fox N (1996). "Oral fluconazole compared with bladder irrigation with amphotericin B for treatment of fungal urinary tract infections in elderly patients". Clin Infect Dis. 22 (1): 30–5. PMID 8824962.

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[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

[23]

[24]

[25]

[26]

[27]

[28]

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[32]

[33]

[34]

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[43]

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@@ Line 1: / Line 1: @@
 __NOTOC__
+{| class="infobox" style="float:right;"
+|-
+| [[File:Siren.gif|30px|link=Pyuria resident survival guide]]|| <br> || <br>
+| [[Pyuria resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
+|}
 {{Pyuria}}
 {{CMG}} {{AE}} {{SSH}}
-<br><br>'''To view a comprehensive algorithm of common findings of urine composition and urine output, click [[Urine#Algorithm of Common Urinary Findings|here]]'''<br>
+<br><br>'''To view a comprehensive algorithm of common findings of urine composition and urine output, click [[Urine#Algorithm of Common Urinary Findings|here]]'''
 ==Overview==
-Pyuria refers to urine which contains pus. Defined as the presence of 10 or more [[neutrophils]] per high power field of unspun, voided mid-stream urine. It can be a sign of a bacterial [[urinary tract infection]]. Pyuria may be present in the septic patient, or in an older patient with [[pneumonia]]. Sterile pyuria is urine which contains [[white blood cell]]s (pus) while appearing sterile by standard culture techniques.  Sterile pyuria is listed as a side-effect from some medications such as [[paracetamol|paracetamol (acetaminophen)]].
+Pyuria is a condition in which urine contains  10 or more white cells/mm³. [[Gram staining|Gram stain]] and [[leukocyte esterase]] might be positive. Pyuria might be a sign of a bacterial or non bacterial [[urinary tract infection]], genitourinary abnormalities, inflammatory disorders, and systemic diseases. Pyuria may be classified into sterile pyuria or [[bacteriuria]]. Treatment is not required for pyuria. However, underlying diseases must be treated.
 ==Definition==
-Pyuria is defined as the presence of 10 or more white cells per cubic millimeter in a urine specimen, 3 or more white cells per high-power field of unspun urine, a positive result on Gram’s stain of an unspun urine specimen, or a urinary dipstick test that is positive for leukocyte esterase<ref>{{Cite journal| doi = 10.1016/j.ajic.2008.03.002| issn = 1527-3296| volume = 36| issue = 5| pages = 309–332| last1 = Horan| first1 = Teresa C.| last2 = Andrus| first2 = Mary| last3 = Dudeck| first3 = Margaret A.| title = CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting| journal = American Journal of Infection Control| date = 2008-06| pmid = 18538699}}</ref>
+Pyuria is a condition in which urine contains pus. Definition of pyuria is as follow:<ref>{{Cite journal| doi = 10.1016/j.ajic.2008.03.002| issn = 1527-3296| volume = 36| issue = 5| pages = 309–332| last1 = Horan| first1 = Teresa C.| last2 = Andrus| first2 = Mary| last3 = Dudeck| first3 = Margaret A.| title = CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting| journal = American Journal of Infection Control| date = 2008-06| pmid = 18538699}}</ref>
+* Presence of 10 or more white cells/mm³ in a urine specimen
+* Positive result on Gram’s stain of an unspun urine specimen
+* Positive leukocyte esterase on urinary dipstick test
+Pyuria might be a sign of a bacterial or non bacterial [[urinary tract infection]].
 ==Classification==
-Pyuria may be classified based on the presence/absence of detectable infection as shown below:
+Pyuria may be classified based on the presence of detectable infection as shown below:<ref>{{Cite journal| doi = 10.1056/NEJMra1410052| issn = 1533-4406| volume = 372| issue = 11| pages = 1048–1054| last1 = Wise| first1 = Gilbert J.| last2 = Schlegel| first2 = Peter N.| title = Sterile pyuria| journal = The New England Journal of Medicine| date = 2015-03-12| pmid = 25760357}}</ref><ref>{{Cite journal| doi = 10.1309/AJCP4KVGQZEG1YDM| issn = 1943-7722| volume = 137| issue = 5| pages = 778–784| last1 = Kwon| first1 = Jennie H.| last2 = Fausone| first2 = Maureen K.| last3 = Du| first3 = Hongyan| last4 = Robicsek| first4 = Ari| last5 = Peterson| first5 = Lance R.| title = Impact of laboratory-reported urine culture colony counts on the diagnosis and treatment of urinary tract infection for hospitalized patients| journal = American Journal of Clinical Pathology| date = 2012-05| pmid = 22523217}}</ref>
-*'''Sterile pyuria''': the persistent finding of white cells in the urine in the absence of bacteria, as determined by means of aerobic laboratory techniques (on a 5% sheep-blood agar plate and MacConkey agar plate)<ref>{{Cite journal| doi = 10.1056/NEJMra1410052| issn = 1533-4406| volume = 372| issue = 11| pages = 1048–1054| last1 = Wise| first1 = Gilbert J.| last2 = Schlegel| first2 = Peter N.| title = Sterile pyuria| journal = The New England Journal of Medicine| date = 2015-03-12| pmid = 25760357}}</ref>
+{|
-*'''Bacteriuria''': bacterial colony counts of more than 1000 colony-forming units (CFU) per milliliter in urine<ref>{{Cite journal| doi = 10.1309/AJCP4KVGQZEG1YDM| issn = 1943-7722| volume = 137| issue = 5| pages = 778–784| last1 = Kwon| first1 = Jennie H.| last2 = Fausone| first2 = Maureen K.| last3 = Du| first3 = Hongyan| last4 = Robicsek| first4 = Ari| last5 = Peterson| first5 = Lance R.| title = Impact of laboratory-reported urine culture colony counts on the diagnosis and treatment of urinary tract infection for hospitalized patients| journal = American Journal of Clinical Pathology| date = 2012-05| pmid = 22523217}}</ref>
+! colspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Classification of pyuria
-{| class="wikitable"
-!
-!Cell
-!Bacteria
-!
 |-
-|'''Sterile pyuria'''
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Group
-| +
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Cell count
-| -
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bacteria
-|
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
 |-
-|'''Bacteriuria'''
+! align="center" style="background:#DCDCDC;" + |Sterile pyuria
-| +
+| align="center" style="background:#F5F5F5;" + | ↑
-| +
+| align="center" style="background:#F5F5F5;" + | -
-|
+| align="left" style="background:#F5F5F5;" + |Might have infectious or non-infectious etiologies.
 |-
-|
+! align="center" style="background:#DCDCDC;" + |Bacteriuria
-|
+| align="center" style="background:#F5F5F5;" + | ↑
-|
+| align="center" style="background:#F5F5F5;" + |Positive bacterial colony >1000 colony-forming units/ml
-|
+| align="left" style="background:#F5F5F5;" + |Mostly have infectious etiologies.
 |}
-== Causes ==
+==Pyuria Differential Diagnosis==
-In Alphabetical Order<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
+'''Differentiating the diseases that can cause pyuria:'''<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>
-*[[Colpitis]]
-*[[Cystitis]]
-*[[Epididymitis]]
-*[[tuberculosis|Genitourinary tuberculosis]]
-*[[Interstitial Nephritis]]
-*[[Neoplasm]]
-*[[Prostitis]]
-*[[Pyelonephritis ]]
-*[[Renal Carcinoma]]
-*[[Renal papillary necrosis]]
-*[[Urethritis]]
-*[[Vaginitis]]
-*[[Vulvitis]]
-== Pyuria Differential Diagnosis ==
-=== Differentiating the diseases that can cause pyuria: ===
+'''To review differential diagnosis of sterile pyuria, click [[Sterile pyuria differential diagnosis|here]].'''
 {|
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
 ! rowspan="5" |Category
 ! colspan="3" rowspan="5" |Disease
-! colspan="10" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Clinical manifestations
+! colspan="9" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Clinical manifestations
-! colspan="10" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
+! colspan="8" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para−clinical findings
 ! colspan="1" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard for diagnosis
 ! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
 |-
 ! colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
-! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
+! colspan="2" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
 |-
 ! colspan="7" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
-! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
+! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
 |-
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pain
@@ Line 75: / Line 63: @@
 ! colspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinary symptoms
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
-! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Edema
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |CBC
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Electrolytes
 ! colspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinalysis
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ultrasound
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
 |-
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dysuria
@@ Line 94: / Line 78: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
 |-
-! rowspan="12" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infectious diseases
+! rowspan="16" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infectious diseases
-! rowspan="9" align="center" style="background:#DCDCDC;" + |[[Urinary tract infection|UTI]]
+! rowspan="14" align="center" style="background:#DCDCDC;" + |[[Urinary tract infection|UTI]]<ref name="pmid18061020">{{cite journal |vauthors=Neal DE |title=Complicated urinary tract infections |journal=Urol. Clin. North Am. |volume=35 |issue=1 |pages=13–22; v |date=February 2008 |pmid=18061020 |doi=10.1016/j.ucl.2007.09.010 |url=}}</ref>
 ! rowspan="3" align="center" style="background:#DCDCDC;" + |[[Bacteria|Bacterial]]
-! align="center" style="background:#DCDCDC;" + |[[Asymptomatic bacteriuria]]
+! 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>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |±
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |NA
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |NA
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |[[Urine|Urinalysis]]
-| align="center" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+*Increased risk in [[pregnancy]]
-| align="center" style="background:#F5F5F5;" + |
+*Must be treated prior to an invasive urologic procedure
+|-
+! align="center" style="background:#DCDCDC;" + |[[Cystitis]]<ref name="pmid28613784">{{cite journal |vauthors=Sabih A, Leslie SW |title= |journal= |volume= |issue= |pages= |date= |pmid=28613784 |doi= |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="left" style="background:#F5F5F5;" + |
+*[[Nitrite]] +
+*[[Leukocyte esterase]] +
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |[[Urine|Urinalysis]]
+| align="center" style="background:#F5F5F5;" + |NA
+|-
+! align="center" style="background:#DCDCDC;" + |[[Pyelonephritis]]<ref name="pmid28087935">{{cite journal |vauthors=Pietrucha-Dilanchian P, Hooton TM |title=Diagnosis, Treatment, and Prevention of Urinary Tract Infection |journal=Microbiol Spectr |volume=4 |issue=6 |pages= |date=December 2016 |pmid=28087935 |doi=10.1128/microbiolspec.UTI-0021-2015 |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+*[[Leukocytosis]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |WBC cast
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="left" style="background:#F5F5F5;" + |
+*[[Nitrite]] +
+*[[Leukocyte esterase]] +
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation + [[Urine|urinalysis]]
+| align="center" style="background:#F5F5F5;" + |NA
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Virus|Viral]]<ref name="pmid23816478">{{cite journal |vauthors=Aboumohamed A, Flechner SM, Chiesa-Vottero A, Srinivas TR, Mossad SB |title=Disseminated adenoviral infection masquerading as lower urinary tract voiding dysfunction in a kidney transplant recipient |journal=Clin. Nephrol. |volume=82 |issue=5 |pages=332–6 |date=November 2014 |pmid=23816478 |doi=10.5414/CN107977 |url=}}</ref><ref name="pmid25667584">{{cite journal |vauthors=Santiago-Rodriguez TM, Ly M, Bonilla N, Pride DT |title=The human urine virome in association with urinary tract infections |journal=Front Microbiol |volume=6 |issue= |pages=14 |date=2015 |pmid=25667584 |pmc=4304238 |doi=10.3389/fmicb.2015.00014 |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |PCR viral load
+| align="left" style="background:#F5F5F5;" + |
+* Increased risk in immunosuppressed [[Kidney transplantation|kidney transplant]] patients
+*[[Cytomegalovirus infection|CMV]], [[Epstein Barr virus|EBV]], [[BK virus]], [[Adenoviridae|adenovirus]] might be seen
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Tuberculosis]]<ref name="pmid26123266">{{cite journal |vauthors=Altiparmak MR, Trabulus S, Balkan II, Yalin SF, Denizli N, Aslan G, Doruk HE, Engin A, Tekin R, Birengel S, Cetin BD, Arslan F, Turhan V, Mert A |title=Urinary tuberculosis: a cohort of 79 adult cases |journal=Ren Fail |volume=37 |issue=7 |pages=1157–63 |date=August 2015 |pmid=26123266 |doi=10.3109/0886022X.2015.1057460 |url=}}</ref><ref name="pmid27865246">{{cite journal |vauthors=Verma AK, Mishra AK, Kumar M, Kant S, Singh A, Singh A |title=Renal tuberculosis presenting as acute pyelonephritis - A rarity |journal=Indian J Tuberc |volume=63 |issue=3 |pages=210–213 |date=July 2016 |pmid=27865246 |doi=10.1016/j.ijtb.2015.07.010 |url=}}</ref><ref name="pmid23303798">{{cite journal |vauthors=Daher Ede F, da Silva GB, Barros EJ |title=Renal tuberculosis in the modern era |journal=Am. J. Trop. Med. Hyg. |volume=88 |issue=1 |pages=54–64 |date=January 2013 |pmid=23303798 |pmc=3541747 |doi=10.4269/ajtmh.2013.12-0413 |url=}}</ref><ref name="pmid28784884">{{cite journal |vauthors=Czapka M, Shukla S, Slosar-Cheah M |title=Urine trouble: genitourinary tuberculosis and subsequent DRESS syndrome |journal=BMJ Case Rep |volume=2017 |issue= |pages= |date=August 2017 |pmid=28784884 |doi=10.1136/bcr-2017-220440 |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Positive mycobacterial urine culture
+| align="left" style="background:#F5F5F5;" + |
+*[[Microscopic hematuria]]
+| align="center" style="background:#F5F5F5;" + |[[Tuberculosis|Pulmonary TB]] on chest CT
+| align="center" style="background:#F5F5F5;" + |Urine mycobacterial [[Polymerase chain reaction|PCR]]
+| align="left" style="background:#F5F5F5;" + |
+*Past history of [[Tuberculosis|pulmonary TB]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Fungal]]<ref name="pmid22025959">{{cite journal |vauthors=Kim J, Kim DS, Lee YS, Choi NG |title=Fungal urinary tract infection in burn patients with long-term foley catheterization |journal=Korean J Urol |volume=52 |issue=9 |pages=626–31 |date=September 2011 |pmid=22025959 |pmc=3198237 |doi=10.4111/kju.2011.52.9.626 |url=}}</ref><ref name="pmid11980593">{{cite journal |vauthors=Carvalho M, Guimarães CM, Mayer JR, Bordignon GP, Queiroz-Telles F |title=Hospital-associated funguria: analysis of risk factors, clinical presentation and outcome |journal=Braz J Infect Dis |volume=5 |issue=6 |pages=313–8 |date=December 2001 |pmid=11980593 |doi= |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | + after several weeks of follow up
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |[[Hydronephrosis]] on ultrasound
+| align="center" style="background:#F5F5F5;" + |[[Urine culture]]
+| align="left" style="background:#F5F5F5;" + |
+*Increased risk in patients with long−term foley [[Catheter|catheters]]
+*[[Candidiasis|Candida]] as the most prevalent fungus
+|-
+! rowspan="7" align="center" style="background:#DCDCDC;" + |[[Sexually transmitted disease|STD]]
+! align="center" style="background:#DCDCDC;" + |[[Chlamydia]]<ref name="MatthewsBonigal1990">{{cite journal|last1=Matthews|first1=R.S.|last2=Bonigal|first2=S.D.|last3=Wise|first3=R.|title=Sterile pyuria and Chlamydia trachomatis|journal=The Lancet|volume=336|issue=8711|year=1990|pages=385|issn=01406736|doi=10.1016/0140-6736(90)91936-5}}</ref><ref name="pmid8733337">{{cite journal |vauthors=Tayal SC, Pattman RS |title=Sterile pyuria: consider chlamydial infection |journal=Br J Clin Pract |volume=50 |issue=3 |pages=166–7 |date=1996 |pmid=8733337 |doi= |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + |Chronic [[Causes of pelvic pain|pelvic pain]]
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="left" style="background:#F5F5F5;" + |
+*[[Tenderness (medicine)|Abdominal tenderness]]
+*[[Adnexa|Adnexal]] motion [[tenderness]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |[[Polymerase chain reaction|PCR]]
+| align="left" style="background:#F5F5F5;" + |
+*Females might have concurrent chlamydial [[cervicitis]]
+*Must be considered in young, sexually active males
 |-
-! align="center" style="background:#DCDCDC;" + |[[Cystitis]]
+! align="center" style="background:#DCDCDC;" + |[[Gonococcus]]<ref name="pmid6799059">{{cite journal |vauthors=Clarke M, Maskell R |title=Gonorrhoea presenting as "sterile" pyuria |journal=Br Med J (Clin Res Ed) |volume=283 |issue=6305 |pages=1546 |date=December 1981 |pmid=6799059 |pmc=1507898 |doi= |url=}}</ref><ref name="pmid9389943">{{cite journal |vauthors=Jephcott AE |title=Microbiological diagnosis of gonorrhoea |journal=Genitourin Med |volume=73 |issue=4 |pages=245–52 |date=August 1997 |pmid=9389943 |pmc=1195851 |doi= |url=}}</ref><ref name="pmid26063863">{{cite journal |vauthors=Tomas ME, Getman D, Donskey CJ, Hecker MT |title=Overdiagnosis of Urinary Tract Infection and Underdiagnosis of Sexually Transmitted Infection in Adult Women Presenting to an Emergency Department |journal=J. Clin. Microbiol. |volume=53 |issue=8 |pages=2686–92 |date=August 2015 |pmid=26063863 |pmc=4508438 |doi=10.1128/JCM.00670-15 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Chronic [[Causes of pelvic pain|pelvic pain]]
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+*[[Tenderness (medicine)|Abdominal tenderness]]
-| align="center" style="background:#F5F5F5;" + |
+*[[Adnexa|Adnexal]] motion [[tenderness]]
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+High false negative result
-| align="center" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+*Intracellular gram−negative [[Diplococcus|diplococci]] on [[Gram staining|gram stain]]
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |NA
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |[[Nucleic acid amplification technique|Nucleic acid amplification]] testing (NAAT)
+| align="left" style="background:#F5F5F5;" + |
+*Females might have concurrent cervical [[Gonorrhea|gonococcal infection]]
+*Must be considered in young, sexually active males
 |-
-! align="center" style="background:#DCDCDC;" + |[[Pyelonephritis]]
+! align="center" style="background:#DCDCDC;" + |[[Ureaplasma urealyticum]]<ref name="pmid18614434">{{cite journal |vauthors=Nassar FA, Abu-Elamreen FH, Shubair ME, Sharif FA |title=Detection of Chlamydia trachomatis and Mycoplasma hominis, genitalium and Ureaplasma urealyticum by polymerase chain reaction in patients with sterile pyuria |journal=Adv Med Sci |volume=53 |issue=1 |pages=80–6 |date=2008 |pmid=18614434 |doi=10.2478/v10039-008-0020-1 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+*Gram stain −
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |NA
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |[[Polymerase chain reaction|PCR]]
-| align="center" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+*Associated with complications of pregnancy
-| align="center" style="background:#F5F5F5;" + |
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Virus|Viral]]
+! align="center" style="background:#DCDCDC;" + |[[Herpes simplex virus]]<ref name="pmid16926356">{{cite journal |vauthors=Xu F, Sternberg MR, Kottiri BJ, McQuillan GM, Lee FK, Nahmias AJ, Berman SM, Markowitz LE |title=Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States |journal=JAMA |volume=296 |issue=8 |pages=964–73 |date=August 2006 |pmid=16926356 |doi=10.1001/jama.296.8.964 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+*Painful [[Genital ulcer|genital ulcers]]
-| align="center" style="background:#F5F5F5;" + |
+*Tender local inguinal [[lymphadenopathy]]
-| align="center" style="background:#F5F5F5;" + |
+*Acute [[urinary retention]]
-| align="center" style="background:#F5F5F5;" + |
+*Loss of sacral sensation
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Viral culture +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |NA
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |NA
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation + [[Polymerase chain reaction|PCR]]
+| align="left" style="background:#F5F5F5;" + |
+*Associated with extragenital complications, like [[Meningitis|aseptic meningitis]]
+*High risk of recurrence
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Tuberculosis]]
+! align="center" style="background:#DCDCDC;" + |[[Herpes zoster]]<ref name="ChenHsueh2002">{{cite journal|last1=Chen|first1=Po-Hong|last2=Hsueh|first2=Hsiu-Fang|last3=Hong|first3=Chang-Zern|title=Herpes zoster–associated voiding dysfunction: A retrospective study and literature review|journal=Archives of Physical Medicine and Rehabilitation|volume=83|issue=11|year=2002|pages=1624–1628|issn=00039993|doi=10.1053/apmr.2002.34602}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+*[[Rash]]
-| align="center" style="background:#F5F5F5;" + |
+*Acute [[neuritis]]
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* [[Microscopic hematuria]]
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |NA
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation + [[Polymerase chain reaction|PCR]]
-| align="center" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |
+*Associated with lumbosacral [[dermatome]] involvement
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Fungal]]
+! align="center" style="background:#DCDCDC;" + |[[Human papillomavirus|HPV]]<ref name="pmid16819332">{{cite journal |vauthors=Guo CC, Fine SW, Epstein JI |title=Noninvasive squamous lesions in the urinary bladder: a clinicopathologic analysis of 29 cases |journal=Am. J. Surg. Pathol. |volume=30 |issue=7 |pages=883–91 |date=July 2006 |pmid=16819332 |doi=10.1097/01.pas.0000213283.20166.5a |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*[[Genital warts|Genital wart]]
+*[[Cancer|Cancerous]] lesions of the [[Sex organ|genitalia]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation + [[Polymerase chain reaction|PCR]]
 | align="center" style="background:#F5F5F5;" + |
+*Associated with [[Bladder cancer|bladder carcinoma]]
+*Prevented by [[HPV Vaccine|HPV vaccination]]
 |-
-! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Urethritis]]
+! align="center" style="background:#DCDCDC;" + |[[Human Immunodeficiency Virus (HIV)|HIV]]<ref name="pmid20338962">{{cite journal |vauthors=Parkhie SM, Fine DM, Lucas GM, Atta MG |title=Characteristics of patients with HIV and biopsy-proven acute interstitial nephritis |journal=Clin J Am Soc Nephrol |volume=5 |issue=5 |pages=798–804 |date=May 2010 |pmid=20338962 |pmc=2863972 |doi=10.2215/CJN.08211109 |url=}}</ref>
-! align="center" style="background:#DCDCDC;" + |[[Chlamydia]]
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*Painful mucocutaneous ulceration
+*[[Lymphadenopathy]]
+*[[Meningitis|Aseptic meningitis]]
+*[[Diarrhea]]
+*[[Weight loss]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Leukopenia]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |Combination antigen/antibody immunoassay + PCR [[Human Immunodeficiency Virus (HIV)|HIV]] viral load test
 | align="center" style="background:#F5F5F5;" + |
+*Might be gone to chronic [[Human Immunodeficiency Virus (HIV)|HIV]] infection with or without evidence of the [[Immunodeficiency|acquired immunodeficiency syndrome]] ([[HIV AIDS|AIDS]])
+*Associated with acute [[interstitial nephritis]]
 |-
-! align="center" style="background:#DCDCDC;" + |[[Gonococcus]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Prostatitis]]<ref name="pmid23519458">{{cite journal |vauthors=Wagenlehner FM, Pilatz A, Bschleipfer T, Diemer T, Linn T, Meinhardt A, Schagdarsurengin U, Dansranjavin T, Schuppe HC, Weidner W |title=Bacterial prostatitis |journal=World J Urol |volume=31 |issue=4 |pages=711–6 |date=August 2013 |pmid=23519458 |doi=10.1007/s00345-013-1055-x |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | Pelvic or perineal pain
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl or ↑
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*Dribbling of urine
+*Firm and tender [[prostate]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Leukocytosis]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + |
+*Cloudy urine
+*Positive [[Gram staining|gram stain]]
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation + [[Urine|urinalysis]]
 | align="center" style="background:#F5F5F5;" + |
+*Increased risk of [[bacteremia]], prostatic abscess, and metastatic infection
+*Might be acute or chronic infection
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Prostatitis]]
+! colspan="3" align="center" style="background:#DCDCDC;" + |[[Balanitis]]<ref name="pmid25596845">{{cite journal |vauthors=Hsu CY, Lin CL, Kao CH |title=Balanitis is a risk factor for herpes zoster |journal=Eur. J. Clin. Microbiol. Infect. Dis. |volume=34 |issue=5 |pages=985–90 |date=May 2015 |pmid=25596845 |doi=10.1007/s10096-015-2314-0 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Penile pain
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*[[Pruritus]]
+*Erythematous lesions on the glans and/or the foreskin
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |±
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation
 | align="center" style="background:#F5F5F5;" + |
+*Associated with [[reactive arthritis]]
 |-
-! colspan="3" align="center" style="background:#DCDCDC;" + |[[Balanitis]]
+! colspan="3" align="center" style="background:#DCDCDC;" + |[[Appendicitis]]<ref name="pmid11343547">{{cite journal |vauthors=Lee SL, Walsh AJ, Ho HS |title=Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis |journal=Arch Surg |volume=136 |issue=5 |pages=556–62 |date=May 2001 |pmid=11343547 |doi= |url=}}</ref><ref name="pmid25345259">{{cite journal |vauthors=Mahattanobon S, Samphao S, Pruekprasert P |title=Clinical features of complicated acute appendicitis |journal=J Med Assoc Thai |volume=97 |issue=8 |pages=835–40 |date=August 2014 |pmid=25345259 |doi= |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Right lower abdominal pain
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*Right lower [[Tenderness (medicine)|abdominal tenderness]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Leukocytosis]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+*Urine [[specific gravity]] >1.020
+| align="center" style="background:#F5F5F5;" + |Enlarged appendiceal diameter on CT scan or ultrasound
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation
+| align="center" style="background:#F5F5F5;" + |NA
 |-
-! colspan="3" align="center" style="background:#DCDCDC;" + |[[PID]]
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
-| align="center" style="background:#F5F5F5;" + |
+! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pain
-| align="center" style="background:#F5F5F5;" + |
+! colspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |N/V
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dysuria
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Frequency
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urgency
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gross hematuria
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other PE
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CBC
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Electrolytes
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Cell
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Cast
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bacteriuria
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Culture
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other UA findings
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard for diagnosis
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 |-
-! colspan="3" align="center" style="background:#DCDCDC;" + |[[Appendicitis]]
+! rowspan="19" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Non−infectious diseases
-| align="center" style="background:#F5F5F5;" + |
+! rowspan="7" align="center" style="background:#DCDCDC;" + |[[Urinary tract|Urinary tract disorders]]
-| align="center" style="background:#F5F5F5;" + |
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Urinary catheter|Urinary catheterization]]<ref name="ForsterHaslam2017">{{cite journal|last1=Forster|first1=C.S.|last2=Haslam|first2=D.B.|last3=Jackson|first3=E.|last4=Goldstein|first4=S.L.|title=Utility of a routine urinalysis in children who require clean intermittent catheterization|journal=Journal of Pediatric Urology|volume=13|issue=5|year=2017|pages=488.e1–488.e5|issn=14775131|doi=10.1016/j.jpurol.2017.01.016}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+*[[Leukocytosis]] ±
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="left" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* [[Leukocyte esterase]] ±
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation + [[Urine|urinalysis]]
+| align="left" style="background:#F5F5F5;" + |
+*Predicting [[Urinary tract infection|UTI]] in children who required clean intermittent [[Catheter|catheterization]] by routine [[Urine|urinalysis]]
 |-
-! rowspan="14" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Non-infectious diseases
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Urinary stone|Urinary tract stone]]<ref name="pmid23283137">{{cite journal |vauthors=Fwu CW, Eggers PW, Kimmel PL, Kusek JW, Kirkali Z |title=Emergency department visits, use of imaging, and drugs for urolithiasis have increased in the United States |journal=Kidney Int. |volume=83 |issue=3 |pages=479–86 |date=March 2013 |pmid=23283137 |pmc=3587650 |doi=10.1038/ki.2012.419 |url=}}</ref><ref name="pmid26349951">{{cite journal |vauthors=Singh P, Enders FT, Vaughan LE, Bergstralh EJ, Knoedler JJ, Krambeck AE, Lieske JC, Rule AD |title=Stone Composition Among First-Time Symptomatic Kidney Stone Formers in the Community |journal=Mayo Clin. Proc. |volume=90 |issue=10 |pages=1356–65 |date=October 2015 |pmid=26349951 |pmc=4593754 |doi=10.1016/j.mayocp.2015.07.016 |url=}}</ref>
-! rowspan="6" align="center" style="background:#DCDCDC;" + |[[Urinary tract|Urinary tract disorders]]
+| align="center" style="background:#F5F5F5;" + |Colicky pain
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Urinary catheter|Urinary catheterization]]
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |±
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+* [[Microscopic hematuria]]
+| align="center" style="background:#F5F5F5;" + |Visible stone on [[Computed tomography|CT scan]]
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation
 | align="center" style="background:#F5F5F5;" + |
+*Might cause renal obstruction
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Urinary stone|Urinary tract stone]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Urinary tract neoplasm]]<ref name="pmid23664207">{{cite journal |vauthors=Azuma T, Nagase Y, Oshi M |title=Pyuria predicts poor prognosis in patients with non-muscle-invasive bladder cancer |journal=Clin Genitourin Cancer |volume=11 |issue=3 |pages=331–6 |date=September 2013 |pmid=23664207 |doi=10.1016/j.clgc.2013.04.002 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+* [[Microscopic hematuria]]
+| align="center" style="background:#F5F5F5;" + |Visible [[tumor]] on [[Computed tomography|CT scan]]
+| align="center" style="background:#F5F5F5;" + |[[Cystoscopy]]  + [[biopsy]]
 | align="center" style="background:#F5F5F5;" + |
+*Associated with non−muscle−invasive [[bladder cancer]] (NMIBC)
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Urinary tract neoplasm]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Fistulae|Urinary fistula]]<ref name="pmid25565512">{{cite journal |vauthors=Hampton BS, Kay A, Pilzek A |title=Urinary fistula and incontinence |journal=Semin. Reprod. Med. |volume=33 |issue=1 |pages=47–52 |date=January 2015 |pmid=25565512 |doi=10.1055/s-0034-1395279 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*[[Urinary incontinence]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |[[Fistula]] on [[cystoscopy]] or [[IVP]]
+| align="center" style="background:#F5F5F5;" + |Physical examination
 | align="center" style="background:#F5F5F5;" + |
+*History of recent surgery
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Fistulae|Urinary fistula]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Interstitial cystitis]]<ref name="pmid22177158">{{cite journal |vauthors=Konkle KS, Berry SH, Elliott MN, Hilton L, Suttorp MJ, Clauw DJ, Clemens JQ |title=Comparison of an interstitial cystitis/bladder pain syndrome clinical cohort with symptomatic community women from the RAND Interstitial Cystitis Epidemiology study |journal=J. Urol. |volume=187 |issue=2 |pages=508–12 |date=February 2012 |pmid=22177158 |pmc=3894739 |doi=10.1016/j.juro.2011.10.040 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Chronic bladder pain
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*[[Tenderness (medicine)|Abdominal tenderness]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation
+| align="center" style="background:#F5F5F5;" + |Associated with other chronic pain syndromes
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Interstitial cystitis]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Vesicoureteral reflux]]<ref name="pmid24012582">{{cite journal |vauthors=Hubert KC, Kokorowski PJ, Huang L, Prasad MM, Rosoklija I, Retik AB, Nelson CP |title=New contralateral vesicoureteral reflux after unilateral ureteral reimplantation: predictive factors and clinical outcomes |journal=J. Urol. |volume=191 |issue=2 |pages=451–7 |date=February 2014 |pmid=24012582 |pmc=4123205 |doi=10.1016/j.juro.2013.08.076 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*[[Oliguria]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Imaging
 | align="center" style="background:#F5F5F5;" + |
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Irradiation|Pelvic irradiation]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hydronephrosis]]<ref name="pmid26194290">{{cite journal |vauthors=Dancz CE, Walker D, Thomas D, Özel B |title=Prevalence of Hydronephrosis in Women With Advanced Pelvic Organ Prolapse |journal=Urology |volume=86 |issue=2 |pages=250–4 |date=August 2015 |pmid=26194290 |doi=10.1016/j.urology.2015.05.005 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*[[Oliguria]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Imaging
 | align="center" style="background:#F5F5F5;" + |
 |-
 ! rowspan="5" align="center" style="background:#DCDCDC;" + |[[Renal disease|Renal diseases]]
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Polycystic kidney disease|Polycystic kidney disease]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Polycystic kidney disease|Polycystic kidney disease]]<ref name="pmid25186187">{{cite journal |vauthors=Paul BM, Vanden Heuvel GB |title=Kidney: polycystic kidney disease |journal=Wiley Interdiscip Rev Dev Biol |volume=3 |issue=6 |pages=465–87 |date=2014 |pmid=25186187 |pmc=4423807 |doi=10.1002/wdev.152 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | Flank or [[back]] [[pain]]
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |
+*[[Polyuria]]
+*[[Nocturia]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+*[[Hypocitraturia]]
+*[[Hyperuricemia]]
+*[[Hyperoxaluria]]
+*[[Urine|Low urine pH]]
+*[[Microscopic hematuria]]
+*[[Proteinuria]] <1 g/day
+| align="center" style="background:#F5F5F5;" + |Multiple cysts on [[ultrasound]]
+| align="center" style="background:#F5F5F5;" + |Imaging
 | align="center" style="background:#F5F5F5;" + |
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal vein thrombosis]]<ref name="pmid18158362">{{cite journal |vauthors=Mahmoodi BK, ten Kate MK, Waanders F, Veeger NJ, Brouwer JL, Vogt L, Navis G, van der Meer J |title=High absolute risks and predictors of venous and arterial thromboembolic events in patients with nephrotic syndrome: results from a large retrospective cohort study |journal=Circulation |volume=117 |issue=2 |pages=224–30 |date=January 2008 |pmid=18158362 |doi=10.1161/CIRCULATIONAHA.107.716951 |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + |Flank pain
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |Nl or ↑
 | align="center" style="background:#F5F5F5;" + |
+*Might be asymptomatic
+*Signs of [[Acute kidney injury|acute renal failure]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Leukocytosis]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Hyperkalemia]]
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+*[[Proteinuria]]
+*[[Microscopic hematuria]]
+| align="center" style="background:#F5F5F5;" + |[[Thrombosis]] on CT scan
+| align="center" style="background:#F5F5F5;" + |Renal [[venography]]
 | align="center" style="background:#F5F5F5;" + |
+*Increased risk in [[nephrotic syndrome]] and [[Thrombophilia|hypercoagulable state]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Interstitial nephritis]]<ref name="pmid25079860">{{cite journal |vauthors=Raghavan R, Eknoyan G |title=Acute interstitial nephritis - a reappraisal and update |journal=Clin. Nephrol. |volume=82 |issue=3 |pages=149–62 |date=September 2014 |pmid=25079860 |pmc=4928030 |doi= |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + |[[Low back pain|Lower back pain]]
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Nl or ↑
 | align="center" style="background:#F5F5F5;" + |
+*[[Rash]]
+*[[Weight loss]]
+*[[Oliguria]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Eosinophilia]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Hyperkalemia]]
+*[[Isosthenuria]]
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+*[[Proteinuria]]
+*[[Eosinophiluria]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation + [[Urine|urinalysis]]
 | align="center" style="background:#F5F5F5;" + |
+*Associated with [[medications]], particularly [[Antibiotic|antibiotics]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[IgA nephropathy]]<ref name="pmid24861083">{{cite journal |vauthors=Roberts IS |title=Pathology of IgA nephropathy |journal=Nat Rev Nephrol |volume=10 |issue=8 |pages=445–54 |date=August 2014 |pmid=24861083 |doi=10.1038/nrneph.2014.92 |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |Nl or ↑
 | align="center" style="background:#F5F5F5;" + |
+*Might be asymptomatic
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+*[[Proteinuria]]
+*[[Microscopic hematuria]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |[[Biopsy]]
 | align="center" style="background:#F5F5F5;" + |
+*History of [[Acute viral nasopharyngitis (common cold)|upper respiratory infection]]
+|-
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Kidney transplantation|Renal transplant rejection]]<ref name="pmid29789350">{{cite journal |vauthors=Martin-Moreno PL, Tripathi S, Chandraker A |title=Regulatory T Cells and Kidney Transplantation |journal=Clin J Am Soc Nephrol |volume= |issue= |pages= |date=May 2018 |pmid=29789350 |doi=10.2215/CJN.01750218 |url=}}</ref>
+| align="center" style="background:#F5F5F5;" + |Flank pain
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |
+*Might be asymptomatic
+*[[Oliguria]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Leukocytosis]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+*[[Proteinuria]]
+*[[Microscopic hematuria]]
+| align="center" style="background:#F5F5F5;" + |Increased graft size on ultrasound
+| align="center" style="background:#F5F5F5;" + |Renal allograft [[biopsy]]
 | align="center" style="background:#F5F5F5;" + |
+*Acute rise in the [[Creatinine|serum creatinine]]
+*History of [[Organ transplant|transplant]]
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal vein thrombosis]]
+! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pain
-| align="center" style="background:#F5F5F5;" + |
+! colspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |N/V
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dysuria
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Frequency
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urgency
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gross hematuria
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other PE
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CBC
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Electrolytes
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Cell
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Cast
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bacteriuria
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Culture
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other UA findings
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard for diagnosis
-| align="center" style="background:#F5F5F5;" + |
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Interstitial nephritis]]
+! rowspan="4" align="center" style="background:#DCDCDC;" + |[[Systemic disease]]
-| align="center" style="background:#F5F5F5;" + |
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Diabetic nephropathy]]<ref name="pmid24983394">{{cite journal |vauthors=Bjornstad P, Cherney D, Maahs DM |title=Early diabetic nephropathy in type 1 diabetes: new insights |journal=Curr Opin Endocrinol Diabetes Obes |volume=21 |issue=4 |pages=279–86 |date=August 2014 |pmid=24983394 |pmc=4138314 |doi=10.1097/MED.0000000000000074 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |±
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*Might be asymptomatic
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+*[[Albuminuria]]
+*[[Microscopic hematuria]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation + laboratory tests
 | align="center" style="background:#F5F5F5;" + |
+*History of [[retinopathy]] and [[neuropathy]]
+*Slow and progressive [[Renal insufficiency|renal failure]]
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Analgesic nephropathy]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Lupus nephritis]]<ref name="SchwartzGoilav2014">{{cite journal|last1=Schwartz|first1=Noa|last2=Goilav|first2=Beatrice|last3=Putterman|first3=Chaim|title=The pathogenesis, diagnosis and treatment of lupus nephritis|journal=Current Opinion in Rheumatology|volume=26|issue=5|year=2014|pages=502–509|issn=1040-8711|doi=10.1097/BOR.0000000000000089}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*[[Rash]]
+*[[Oral ulcer]]
+*[[Arthritis]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Pancytopenia]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+*[[Hematuria]]
+*[[Proteinuria]]
+| align="center" style="background:#F5F5F5;" + |Enlarged kidneys on CT scan
+| align="center" style="background:#F5F5F5;" + |[[Biopsy]]
 | align="center" style="background:#F5F5F5;" + |
+* Abnormal results of specific serologic tests
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Papillary necrosis]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Sjögren's syndrome|Sjögren’s syndrome]]<ref name="de PaivaRocha2015">{{cite journal|last1=de Paiva|first1=Cintia S.|last2=Rocha|first2=Eduardo Melani|title=Sjögren syndrome|journal=Current Opinion in Ophthalmology|volume=26|issue=6|year=2015|pages=517–525|issn=1040-8738|doi=10.1097/ICU.0000000000000208}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*Dryness of all [[mucous membranes]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Pancytopenia]]
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+*[[Hematuria]]
+*[[Proteinuria]]
+| align="center" style="background:#F5F5F5;" + |Abnormal diffuse [[Adipose tissue|fat tissue]] deposition and diffuse punctate [[calcification]] on parotid gland CT scan
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation + laboratory tests
 | align="center" style="background:#F5F5F5;" + |
+* Abnormal results of specific serologic tests
 |-
-! rowspan="3" align="center" style="background:#DCDCDC;" + |[[Systemic disease]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Kawasaki's disease]]<ref name="pmid14745638">{{cite journal |vauthors=Wirojanan J, Sopontammarak S, Vachvanichsanong P |title=Sterile pyuria in Kawasaki disease |journal=Pediatr. Nephrol. |volume=19 |issue=3 |pages=363 |date=March 2004 |pmid=14745638 |doi=10.1007/s00467-003-1394-8 |url=}}</ref>
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Systemic lupus erythematosus|Systemic lupus erythematosus]]
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*[[Rash]]
+*[[Irritability]]
+*[[Desquamation]] of skin and mucous membranes
 | align="center" style="background:#F5F5F5;" + |
+*[[Normocytic normochromic anemia]]
+*[[Thrombocytosis]]
+*[[Leukocytosis]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Hyponatremia]]
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |Vessels involvement on [[Angiogram|angiography]]
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation
+| align="center" style="background:#F5F5F5;" + |Associated with multiple organ involvement including [[heart]]
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Kawasaki's disease]]
+! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Medication]]/[[toxin]]
-| align="center" style="background:#F5F5F5;" + |
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Analgesic nephropathy]]<ref name="pmid28341428">{{cite journal |vauthors=Henderickx MMEL, Brits T, De Baets K, Seghers M, Maes P, Trouet D, De Wachter S, De Win G |title=Renal papillary necrosis in patients with sickle cell disease: How to recognize this 'forgotten' diagnosis |journal=J Pediatr Urol |volume=13 |issue=3 |pages=250–256 |date=June 2017 |pmid=28341428 |doi=10.1016/j.jpurol.2017.01.020 |url=}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Flank pain
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*Chronic [[headache]]
+*[[Low back pain]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Eosinophilia]]
 | align="center" style="background:#F5F5F5;" + |
+*[[Hyperkalemia]]
+*[[Isosthenuria]]
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+*[[Proteinuria]]
+*[[Eosinophiluria]]
+| align="center" style="background:#F5F5F5;" + |Renal impairment on CT scan
+| align="center" style="background:#F5F5F5;" + |Imaging
 | align="center" style="background:#F5F5F5;" + |
+*Characterized by [[Renal papillary necrosis|papillary necrosis]] and chronic [[interstitial nephritis]]
+*Caused by the chronic use of [[analgesic]] agents
 |-
-! colspan="2" align="center" style="background:#DCDCDC;" + |[[Graft versus host disease|Graft versus host disease (GVHD)]]
+! colspan="2" align="center" style="background:#DCDCDC;" + |[[Contrast induced nephropathy|Contrast−induced nephropathy]]<ref name="PatschanBuschmann2018">{{cite journal|last1=Patschan|first1=D.|last2=Buschmann|first2=I.|last3=Ritter|first3=O.|title=Contrast-Induced Nephropathy: Update on the Use of Crystalloids and Pharmacological Measures|journal=International Journal of Nephrology|volume=2018|year=2018|pages=1–8|issn=2090-214X|doi=10.1155/2018/5727309}}</ref>
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |−
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+*[[Oliguria]]
+| align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + |
+*[[Hyperkalemia]]
+*[[Acidosis]]
+*[[Hyperphosphatemia]]
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |−
+| align="center" style="background:#F5F5F5;" + |−
 | align="center" style="background:#F5F5F5;" + |
+* [[Fractional sodium excretion]] (FENa) <1%
+| align="center" style="background:#F5F5F5;" + |NA
+| align="center" style="background:#F5F5F5;" + |Clinical manifestation + exclusion of other causes of AKI
 | align="center" style="background:#F5F5F5;" + |
+*Associated with reversible type of [[acute kidney injury]]
+*Acute increase in the [[Creatinine|serum creatinine]]
 |-
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
@@ Line 736: / Line 1,001: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gross hematuria
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Edema
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other PE
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CBC
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Electrolytes
@@ Line 744: / Line 1,008: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bacteriuria
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Culture
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other UA findings
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ultrasound
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard for diagnosis
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
 |}
-==Sterile Pyuria==
+== Treatment ==
-===Definition===
-*Sterile pyuria is defined as the persistent finding of white cells in the urine in the absence of detectable bacteria, as determined by means of aerobic laboratory techniques (on a 5% sheep-blood agar plate and MacConkey agar plate)<ref>{{Cite journal| doi = 10.1056/NEJMra1410052| issn = 1533-4406| volume = 372| issue = 11| pages = 1048–1054| last1 = Wise| first1 = Gilbert J.| last2 = Schlegel| first2 = Peter N.| title = Sterile pyuria| journal = The New England Journal of Medicine| date = 2015-03-12| pmid = 25760357}}</ref>
-*Note that sterile pyuria may still be caused by an infectious agent, but the inability to detect the agent on regular urine gram-stain and culture is diagnostic of sterile pyuria.
-===Causes===
-Pyuria may have either an infectious or a non-infectious etiology:<ref>{{Cite journal| issn = 0098-8243| volume = 26| issue = 3| pages = 150–152| last = Dieter| first = R. S.| title = Sterile pyuria: a differential diagnosis| journal = Comprehensive Therapy| date = 2000| pmid = 10984817}}</ref>
-*'''Infectious etiologies'''
-:* Gynecologic infection
-:* Urethritis due to chlamydia, Neisseria gonorrhoeae, mycoplasma, or ureaplasma
-:* Prostatitis
-:* Balanitis
-:* Appendicitis
-:* Viral infection of the lower genitourinary tract
-:* Genitourinary tuberculosis
-:* Fungal infection
-:* Parasitic disease such as trichomoniasis or schistosomiasis
-*'''Non-infectious etiologies'''
-:* Current use of antibiotics
-:* Recently treated urinary tract infection (within past 2 weeks)
-:* Presence or recent use of a urinary catheter
-:* Recent cystoscopy or urologic endoscopy
-:* Urinary tract stones
-:* Foreign body such as surgical mesh in the urethra or a retained stent
-:* Urinary tract neoplasm
-:* Pelvic irradiation
-:* Urinary fistula
-:* Polycystic kidney
-:* Rejection of a renal transplant
-:* Renal-vein thrombosis
-:* Interstitial nephritis or analgesic nephropathy
-:* Papillary necrosis
-:* Interstitial cystitis
-:* Inflammatory disease such as systemic lupus erythematosus or Kawasaki’s disease===Antimicrobial regimen===
-==Treatment==
 *'''Sterile pyuria'''
-:*. '''Pathogen-directed antimicrobial therapy'''<ref>{{Cite journal| doi = 10.1056/NEJMra1410052| issn = 1533-4406| volume = 372| issue = 11| pages = 1048–1054| last1 = Wise| first1 = Gilbert J.| last2 = Schlegel| first2 = Peter N.| title = Sterile pyuria| journal = The New England Journal of Medicine| date = 2015-03-12| pmid = 25760357}}</ref>
+:*'''Pathogen-directed antimicrobial therapy'''<ref>{{Cite journal| doi = 10.1056/NEJMra1410052| issn = 1533-4406| volume = 372| issue = 11| pages = 1048–1054| last1 = Wise| first1 = Gilbert J.| last2 = Schlegel| first2 = Peter N.| title = Sterile pyuria| journal = The New England Journal of Medicine| date = 2015-03-12| pmid = 25760357}}</ref>
 ::* '''Renal Tuberculosis'''
 :::* Preferred regimen: ([[Isoniazid]] 300 mg PO qd for 2 months {{and}} [[Rifampicin]] 450-600 mg qd for 2 months {{and}} [[Ethambutol]] 15-25 mg/kg PO qd for 2 months {{and}} [[Pyrazinamide]] 1500 mg for 2 months) {{then}} ([[Isoniazid]] 300 mg PO qd for 4-6 months {{and}} [[Rifampicin]] 450-600 mg qd for 4-6 months)
@@ Line 810: / Line 1,039: @@
 ==References==
 {{Reflist|2}}
+{{WH}}
+{{WS}}
 [[Category:Urine tests]]
-[[Category:Primary care]]
 [[Category:Emergency medicine]]
 [[Category:Urology]]
 [[Category:Nephrology]]
 [[Category:Infectious Disease Project]]
+[[Category:Up-To-Date]]
-{{WH}}
-{{WS}}