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Pyuria

MedGen UID:
11078
•Concept ID:
C0034359
•
Finding
Synonym: Pyuria (disease)
SNOMED CT: Pus cells in urine (275765006); Pyuria (4800001)
 
HPO: HP:0012085
Monarch Initiative: MONDO:0001953

Definition

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 staining of an unspun urine specimen, or a urinary dipstick test that is positive for leukocyte esterase. [from HPO]

Professional guidelines

PubMed

Diagnosis and treatment of urinary tract infections across age groups.
Chu CM, Lowder JL
Am J Obstet Gynecol 2018 Jul;219(1):40-51. Epub 2018 Jan 2 doi: 10.1016/j.ajog.2017.12.231. PMID: 29305250
Diagnosis, Treatment, and Prevention of Urinary Tract Infection.
Pietrucha-Dilanchian P, Hooton TM
Microbiol Spectr 2016 Dec;4(6) doi: 10.1128/microbiolspec.UTI-0021-2015. PMID: 28087935
Urinary tract infections in children: EAU/ESPU guidelines.
Stein R, Dogan HS, Hoebeke P, Kočvara R, Nijman RJ, Radmayr C, Tekgül S; European Association of Urology; European Society for Pediatric Urology
Eur Urol 2015 Mar;67(3):546-58. Epub 2014 Dec 2 doi: 10.1016/j.eururo.2014.11.007. PMID: 25477258

Recent clinical studies

Etiology

High dose versus low dose standardized cranberry proanthocyanidin extract for the prevention of recurrent urinary tract infection in healthy women: a double-blind randomized controlled trial.
Babar A, Moore L, Leblanc V, Dudonné S, Desjardins Y, Lemieux S, Bochard V, Guyonnet D, Dodin S
BMC Urol 2021 Mar 23;21(1):44. doi: 10.1186/s12894-021-00811-w. PMID: 33757474Free PMC Article
Urinary Tract Infections in Young Children and Infants: Common Questions and Answers.
Veauthier B, Miller MV
Am Fam Physician 2020 Sep 1;102(5):278-285. PMID: 32866365
Diagnosis and treatment of urinary tract infections across age groups.
Chu CM, Lowder JL
Am J Obstet Gynecol 2018 Jul;219(1):40-51. Epub 2018 Jan 2 doi: 10.1016/j.ajog.2017.12.231. PMID: 29305250
Bacteruria and Urinary Tract Infections in the Elderly.
Detweiler K, Mayers D, Fletcher SG
Urol Clin North Am 2015 Nov;42(4):561-8. Epub 2015 Aug 19 doi: 10.1016/j.ucl.2015.07.002. PMID: 26475952
Pyonephrosis.
Watt I, Roylance J
Clin Radiol 1976 Oct;27(4):513-19. doi: 10.1016/s0009-9260(76)80118-3. PMID: 1000895

Diagnosis

Diagnosis and treatment of urinary tract infections across age groups.
Chu CM, Lowder JL
Am J Obstet Gynecol 2018 Jul;219(1):40-51. Epub 2018 Jan 2 doi: 10.1016/j.ajog.2017.12.231. PMID: 29305250
Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months.
Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB
Pediatrics 2011 Sep;128(3):595-610. Epub 2011 Aug 28 doi: 10.1542/peds.2011-1330. PMID: 21873693
Managing urinary tract infections.
Saadeh SA, Mattoo TK
Pediatr Nephrol 2011 Nov;26(11):1967-76. Epub 2011 Mar 16 doi: 10.1007/s00467-011-1801-5. PMID: 21409431Free PMC Article
Urinalysis: a comprehensive review.
Simerville JA, Maxted WC, Pahira JJ
Am Fam Physician 2005 Mar 15;71(6):1153-62. PMID: 15791892
Urinalysis.
Sheets C, Lyman JL
Emerg Med Clin North Am 1986 May;4(2):263-80. PMID: 3516646

Therapy

Diagnosis and treatment of urinary tract infections across age groups.
Chu CM, Lowder JL
Am J Obstet Gynecol 2018 Jul;219(1):40-51. Epub 2018 Jan 2 doi: 10.1016/j.ajog.2017.12.231. PMID: 29305250
Urogenital Tuberculosis.
Figueiredo AA, Lucon AM, Srougi M
Microbiol Spectr 2017 Jan;5(1) doi: 10.1128/microbiolspec.TNMI7-0015-2016. PMID: 28087922
Diagnosis, Treatment, and Prevention of Urinary Tract Infection.
Pietrucha-Dilanchian P, Hooton TM
Microbiol Spectr 2016 Dec;4(6) doi: 10.1128/microbiolspec.UTI-0021-2015. PMID: 28087935
Bacteruria and Urinary Tract Infections in the Elderly.
Detweiler K, Mayers D, Fletcher SG
Urol Clin North Am 2015 Nov;42(4):561-8. Epub 2015 Aug 19 doi: 10.1016/j.ucl.2015.07.002. PMID: 26475952
Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months.
Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB
Pediatrics 2011 Sep;128(3):595-610. Epub 2011 Aug 28 doi: 10.1542/peds.2011-1330. PMID: 21873693

Prognosis

A systematic review and meta-analysis of risk factors and treatment choices in emphysematous pyelonephritis.
Desai R, Batura D
Int Urol Nephrol 2022 Apr;54(4):717-736. Epub 2022 Feb 1 doi: 10.1007/s11255-022-03131-6. PMID: 35103928
Diagnosis and treatment of urinary tract infections across age groups.
Chu CM, Lowder JL
Am J Obstet Gynecol 2018 Jul;219(1):40-51. Epub 2018 Jan 2 doi: 10.1016/j.ajog.2017.12.231. PMID: 29305250
Diagnosis, Treatment, and Prevention of Urinary Tract Infection.
Pietrucha-Dilanchian P, Hooton TM
Microbiol Spectr 2016 Dec;4(6) doi: 10.1128/microbiolspec.UTI-0021-2015. PMID: 28087935
Urinary tract infections in children: EAU/ESPU guidelines.
Stein R, Dogan HS, Hoebeke P, Kočvara R, Nijman RJ, Radmayr C, Tekgül S; European Association of Urology; European Society for Pediatric Urology
Eur Urol 2015 Mar;67(3):546-58. Epub 2014 Dec 2 doi: 10.1016/j.eururo.2014.11.007. PMID: 25477258
Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months.
Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB
Pediatrics 2011 Sep;128(3):595-610. Epub 2011 Aug 28 doi: 10.1542/peds.2011-1330. PMID: 21873693

Clinical prediction guides

Sulopenem for the Treatment of Complicated Urinary Tract Infections Including Pyelonephritis: A Phase 3, Randomized Trial.
Dunne MW, Aronin SI, Das AF, Akinapelli K, Breen J, Zelasky MT, Puttagunta S
Clin Infect Dis 2023 Jan 6;76(1):78-88. doi: 10.1093/cid/ciac704. PMID: 36068705Free PMC Article
A systematic review and meta-analysis of risk factors and treatment choices in emphysematous pyelonephritis.
Desai R, Batura D
Int Urol Nephrol 2022 Apr;54(4):717-736. Epub 2022 Feb 1 doi: 10.1007/s11255-022-03131-6. PMID: 35103928
High dose versus low dose standardized cranberry proanthocyanidin extract for the prevention of recurrent urinary tract infection in healthy women: a double-blind randomized controlled trial.
Babar A, Moore L, Leblanc V, Dudonné S, Desjardins Y, Lemieux S, Bochard V, Guyonnet D, Dodin S
BMC Urol 2021 Mar 23;21(1):44. doi: 10.1186/s12894-021-00811-w. PMID: 33757474Free PMC Article
Diagnosis and treatment of urinary tract infections across age groups.
Chu CM, Lowder JL
Am J Obstet Gynecol 2018 Jul;219(1):40-51. Epub 2018 Jan 2 doi: 10.1016/j.ajog.2017.12.231. PMID: 29305250
Urinary tract infections in children: EAU/ESPU guidelines.
Stein R, Dogan HS, Hoebeke P, Kočvara R, Nijman RJ, Radmayr C, Tekgül S; European Association of Urology; European Society for Pediatric Urology
Eur Urol 2015 Mar;67(3):546-58. Epub 2014 Dec 2 doi: 10.1016/j.eururo.2014.11.007. PMID: 25477258

Recent systematic reviews

A systematic review and meta-analysis of risk factors and treatment choices in emphysematous pyelonephritis.
Desai R, Batura D
Int Urol Nephrol 2022 Apr;54(4):717-736. Epub 2022 Feb 1 doi: 10.1007/s11255-022-03131-6. PMID: 35103928
Pyuria and microbiology in acute bacterial focal nephritis: a systematic review.
Janett S, Milani GP, Faré PB, Renzi S, Giannini O, Bianchetti MG, Lava SA
Minerva Med 2019 Jun;110(3):232-237. Epub 2019 Feb 22 doi: 10.23736/S0026-4806.19.06002-6. PMID: 30809996
Urinary Tract Infection Antibiotic Trial Study Design: A Systematic Review.
Basmaci R, Vazouras K, Bielicki J, Folgori L, Hsia Y, Zaoutis T, Sharland M
Pediatrics 2017 Dec;140(6) doi: 10.1542/peds.2017-2209. PMID: 29187579
Antibiotic prophylaxis for short-term catheter bladder drainage in adults.
Lusardi G, Lipp A, Shaw C
Cochrane Database Syst Rev 2013 Jul 3;2013(7):CD005428. doi: 10.1002/14651858.CD005428.pub2. PMID: 23824735Free PMC Article
Clinical effectiveness and cost-effectiveness of tests for the diagnosis and investigation of urinary tract infection in children: a systematic review and economic model.
Whiting P, Westwood M, Bojke L, Palmer S, Richardson G, Cooper J, Watt I, Glanville J, Sculpher M, Kleijnen J
Health Technol Assess 2006 Oct;10(36):iii-iv, xi-xiii, 1-154. doi: 10.3310/hta10360. PMID: 17014747

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