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It is reasonable to obtain a urine culture in those with signs of systemic infection that may be unable to report urinary symptoms, such as when advanced dementia is present. [30] Systemic signs of infection include a fever or increase in temperature of more than 1.1 °C (2.0 °F) from usual, chills, and an increased white blood cell count .
Bacteriuria accompanied by symptoms is a urinary tract infection while that without is known as asymptomatic bacteriuria. [1] [2] Diagnosis is by urinalysis or urine culture. [3] Escherichia coli is the most common bacterium found. [1] People without symptoms should generally not be tested for the condition. [3] Differential diagnosis include ...
Analysis of the urine may show signs of urinary tract infection. Specifically, the presence of nitrite and white blood cells on a urine test strip in patients with typical symptoms are sufficient for the diagnosis of pyelonephritis, and are an indication for empirical treatment. Blood tests such as a complete blood count may show neutrophilia.
If UTI is suspected, particularly in complicated cases or when urinalysis results are inconclusive, [140] a urine culture may be performed to identify microorganisms if present, obtain a colony count, and carry out antibiotic sensitivity testing. The colony count helps to distinguish between contamination and infection. [141]
Pyuria is the condition of urine containing white blood cells or pus. Defined as the presence of 6-10 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 people with sepsis, or in older people with pneumonia.
Urinalysis is the most useful test to start the work up in a patient of dysuria. Urinalysis positive for nitrite carries a high predictive value of a positive urine culture. Also, urine dipstick showing leukocytes as equal predictive value as the presence of nitrites. When both are present, the predictive value goes even higher.