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The New England Journal of Medicine Mar 2015
Review
Topics: Bacterial Infections; Colony Count, Microbial; Diagnosis, Differential; Female; Humans; Infections; Male; Mycoses; Pyuria; Sexually Transmitted Diseases; Urine; Virus Diseases
PubMed: 25760357
DOI: 10.1056/NEJMra1410052 -
The New England Journal of Medicine Jun 2015
Topics: Female; Humans; Infections; Male; Pyuria; Sexually Transmitted Diseases; Urine
PubMed: 26061856
DOI: 10.1056/NEJMc1504516 -
The New England Journal of Medicine Jun 2015
Topics: Female; Humans; Infections; Male; Pyuria; Sexually Transmitted Diseases; Urine
PubMed: 26061855
DOI: 10.1056/NEJMc1504516 -
The New England Journal of Medicine Jun 2015
Topics: Female; Humans; Infections; Male; Pyuria; Sexually Transmitted Diseases; Urine
PubMed: 26061857
DOI: 10.1056/NEJMc1504516 -
Therapeutic Advances in Urology Oct 2015Sterile pyuria is a common entity. Yet there are no guidelines to address this issue. We have conducted a systematic review over 20 years and reviewed the results.... (Review)
Review
Sterile pyuria is a common entity. Yet there are no guidelines to address this issue. We have conducted a systematic review over 20 years and reviewed the results. Guidelines for assessment, diagnosis and management are developed based on these results.
PubMed: 26425144
DOI: 10.1177/1756287215592570 -
Global Pediatric Health 2021Sterile pyuria is a common finding in pediatric patients. Literature describing the diagnoses as well as clinical characteristics of children with sterile pyuria is... (Review)
Review
Sterile pyuria is a common finding in pediatric patients. Literature describing the diagnoses as well as clinical characteristics of children with sterile pyuria is lacking. This review was performed to establish an evidence-based approach to the differential diagnosis by way of an extensive literature search. The definition of pyuria is inconsistent. The various causes of pediatric sterile pyuria identified were classified as either Infectious or Non-Infectious. Sub-categories of Infectious causes include: Viral Infection, Bacterial Infection, Other Infections (tuberculosis, fungal, parasitic), Sexually Transmitted Infections, Recent Antibiotic Therapy. Non-Infectious causes include: Systemic Disease, Renal Disease, Drug Related, Inflammation adjacent to Genitourinary Tract. Clinicians that encounter pediatric patients with sterile pyuria and persistent symptoms should consider the substantial differential diagnosis described in this study.
PubMed: 34017902
DOI: 10.1177/2333794X21993712 -
Frontiers in Cardiovascular Medicine 2022Kawasaki disease (KD) is an acute systemic vasculitis and is becoming the leading cause of acquired cardiac disease in Children. Sterile pyuria is a known complication...
BACKGROUND
Kawasaki disease (KD) is an acute systemic vasculitis and is becoming the leading cause of acquired cardiac disease in Children. Sterile pyuria is a known complication of KD. However, its associations with the inflammatory reaction severity, IVIG resistance as well as coronary artery lesions (CALs) in KD remain elusive.
AIMS
We aimed to analyze the clinical profiles of sterile pyuria in KD, to determine whether sterile pyuria is an indicator of the disease severity in patients with KD, and to assess the associations between sterile pyuria and IVIG resistance as well as CALs.
METHODS
We prospectively collected data from 702 patients with KD between January 2015 and June 2020. Profiles of patients with sterile pyuria (group A, = 63) were compared to those of patients without sterile pyuria (group B, = 639). The associations between sterile pyuria and IVIG resistance as well as CALs in KD were further determined by univariate and/or multivariate logistic regression analysis.
RESULTS
Sterile pyuria was observed in 9.0% of patients with KD, without predominance in age spectrum and gender. The levels of neutrophil percentages, alanine transaminase, total bilirubin, blood urea nitrogen, creatinine, the incidence of initial IVIG resistance, and rate of moderate/giant coronary artery aneurysms (CAAs) were significantly higher in group A than that in group B. Sterile pyuria was identified as an independent risk factor for initial IVIG resistance, yielding high specificity (92.7%) and low sensitivity (18.5%). However, sterile pyuria was not associated with repeated IVIG resistance and persistence of CALs in KD.
CONCLUSION
The incidence of sterile pyuria is relatively low in KD patients. Patients with sterile pyuria in KD exhibited a more severe inflammatory burden and were more likely to develop the initial IVIG resistance and moderate/giant CAAs. The overall prognosis of KD patients with sterile pyuria was satisfactory.
PubMed: 35647045
DOI: 10.3389/fcvm.2022.856144 -
Comprehensive Therapy 2000Sterile pyuria is not an uncommon laboratory finding. This article explores the major causes of sterile pyuria, including infectious, systemic, structural and... (Review)
Review
Sterile pyuria is not an uncommon laboratory finding. This article explores the major causes of sterile pyuria, including infectious, systemic, structural and physiologic, and drug-related causes. It also discusses the differential diagnosis of eosinophiluria and the basic workup of sterile pyuria.
Topics: Diagnosis, Differential; Humans; Pyuria
PubMed: 10984817
DOI: 10.1007/s12019-000-0001-1 -
Microbiology Spectrum Jan 2017Urogenital tuberculosis is the second most frequent form of extrapulmonary tuberculosis. Starting with a pulmonary focus, 2 to 20% of patients develop urogenital... (Review)
Review
Urogenital tuberculosis is the second most frequent form of extrapulmonary tuberculosis. Starting with a pulmonary focus, 2 to 20% of patients develop urogenital tuberculosis through hematogenous spread to the kidneys, prostate, and epididymis; through the descending collecting system to the ureters, bladder, and urethra; and through the ejaculatory ducts to the genital organs. Urogenital tuberculosis occurs at all age ranges, but it is predominant in males in their fourth and fifth decades. It is a serious, insidious disease, generally developing symptoms only at a late stage, which leads to a diagnostic delay with consequent urogenital organ destruction; there are reports of patients with renal failure as their initial clinical presentation. Although the condition has been long recognized by nephrologists, urologists, and infectious disease specialists, urogenital tuberculosis is still largely unknown. Even when suggestive findings such as hematuria, sterile pyuria, and recurrent urinary infections are present, we rarely remember this diagnostic possibility. Greater knowledge of the features of urogenital tuberculosis then becomes relevant and should emphasize the importance of an early diagnosis.
Topics: Age Factors; Antitubercular Agents; Diagnostic Tests, Routine; Female; Humans; Male; Sex Factors; Tuberculosis, Urogenital
PubMed: 28087922
DOI: 10.1128/microbiolspec.TNMI7-0015-2016 -
Investigative and Clinical Urology Jan 2020To evaluate if preoperative sterile pyuria can be a prognostic factor for intravesical recurrence (IVR) and overall survival (OS)in patients with upper tract urothelial...
PURPOSE
To evaluate if preoperative sterile pyuria can be a prognostic factor for intravesical recurrence (IVR) and overall survival (OS)in patients with upper tract urothelial carcinoma (UTUC) undergoing surgery.
MATERIALS AND METHODS
We retrospectively reviewed the medical records of patients who were diagnosed with UTUC from October 2003 to December 2016 at Korea University Medical Center. Sterile pyuria was defined as urine containing five or more white blood cells per high-power field in the absence of bacteria in urine culture. We used a stepwise multivariable Cox proportional hazards model to assess the independent effects of the prognostic factors for IVR and OS.
RESULTS
We investigated a total of 176 patients who were diagnosed with UTUC. Among them, 91 (51.7%) patients had preoperative sterile pyuria. There were no significant differences in the baseline characteristics between the pyuria and non-pyuria groups concerning tumor grade, T stage, tumor multiplicity, and recurrence history. However, there was a significant difference in the IVR between the two groups. In the multivariable analysis, preoperative sterile pyuria, diabetes mellitus, high-grade tumor, and lymphovascular invasion were revealed as independent risk factors for IVR, and only lymphovascular invasion was identified as an independent risk factor for OS.
CONCLUSIONS
Preoperative sterile pyuria is significantly associated with IVR in patients with UTUC undergoing surgery, but it is not associated with OS. Furthermore, diabetes mellitus, high-grade tumor, and lymphovascular invasion are also independent prognostic factors for these patients.
Topics: Aged; Carcinoma, Transitional Cell; Female; Humans; Leukocyte Count; Male; Middle Aged; Neoplasm Grading; Neoplasm Recurrence, Local; Neoplasm Staging; Outcome Assessment, Health Care; Perioperative Period; Predictive Value of Tests; Prognosis; Pyuria; Risk Assessment; Urologic Neoplasms; Urologic Surgical Procedures
PubMed: 31942463
DOI: 10.4111/icu.2020.61.1.51