1. 신장내과
R2 이경은

2. Definition Pyuria Sterile pyuria WBC > 10/cm2 WBC > 3/HPF
Gram stain(+)
Dipstick test: Leukocyte esterase(+)
Sterile pyuria
Persistent WBC(+) & Bacteria(-)
5% sheep blood agar plate(-), MacConkey agar plate(-)
Female > Male (because of pelvic infection)

3. Cuses of Sterile pyuria
Sexually transmitted infections
Other viral infections
Genitourinary tuberculosis
Fungal infections
Parasite infections
Inflammatory and autoimmune conditions
Inflammation outside the urinary tract and other urologic conditions

4. Cuases of Sterile pyuria
Sexually transmitted infections
Virus: HSV-2, HPV
Infection: Gonorrhea, Chlamydia, Syphilis, mycoplasma, Trichomoniasis
Men: major) Symptomatic urethritis
less commonly) Epididymitis,
Disseminated gonococcal infection
Women: Asymptomatic initially → Pelvic inflammatory disease

5. Cuses of Sterile pyuria
Other viral infections
Adenovirus, BK polymavirus, Cytomegalovirus
Hemorrhagic cystitis in immunocompromised pts
Genitourinary tuberculosis
The most common form of Non-pulmonary tuberculosis after lymphadenopathy
Hematuria, pyuria
Can infect the kidney, ureters, bladder, prostate, genitalia
Cause renal calyceal destruction, calyceal obstruction, Hydronephrosis
Tuberculin skin test, U/C

6. Cuses of Sterile pyuria
Fungal infections
The Most prevalent: Candida infection(C.albicans, C.glabraa, C.tropicalis)
→ Immunocompromised pt.: common source of urosepsis inpatient
DM: Candida
Pt s/p Transplantation: Aspergillosis
Pt with HIV: Cryptococcuria
Urine microscopy, Urine Culture

7. Cuses of Sterile pyuria
Parasite infections
Trichomonas vaginalis(m/c), Schistosoma haematobium
Transmission: Contamination of water by egg-containing feces or urine
Microscopy, RT PCR(100% sensitivity)
Inflammatory and autoimmune conditions
Kawasaki’s dz: sterile pyuria, microscopic hematuria, proteinuria, ass.with Renal involvement

8. Cuses of Sterile pyuria
Inflammation outside the urinary tract and other urologic conditions
Pneumonia, Bacterial septicemia, intraabdominal infection, enteritis, Female genital tract infections

9. Evaluation of Pt with Sterile pyuria
History
P/Ex
Cuture
PCR

10. Reference