Investigations
Your Organisational Guidance
ebpracticenet urges you to prioritise the following organisational guidance:
Cystitis bij de vrouwPublished by: Werkgroep Ontwikkeling Richtlijnen Eerste Lijn (Worel)Last published: 2017La cystite chez la femmePublished by: Groupe de Travail Développement de recommmandations de première ligneLast published: 20171st investigations to order
urinalysis
Test
Performed on clean catch mid-stream dipstick specimen.
Indicated if diagnosis is uncertain, or if complicating features are present.[35]
The presence of haematuria combined with a positive dipstick test for nitrites has a high diagnostic utility for ruling in the diagnosis of urinary tract infection.[32]
Result
positive for leukocyte esterase, nitrites, and haemoglobin
urine microscopy
Test
Performed on clean catch mid-stream dipstick specimen.
Greater than 10 WBC per high-powered field of an unspun urine is considered diagnostic.
Microscopic detection of red blood cells instead of haemoglobin excludes false-positive urinalysis results from myoglobin or haemoglobin. Epithelial cells suggest a contaminated specimen.
Result
presence of red blood cells, white blood cells, and bacteria
urine culture with sensitivity
Test
Performed on clean catch mid-stream dipstick specimen.[36]
Greater than 10³ colony-forming units/mL of urine is the gold standard of diagnosis. Many laboratories use the cutoff of only 10⁴ colony-forming units/mL of urine. For a suprapubic aspirate, the cutoff of only 10² colony-forming units/mL of urine should be applied.[37]
Most specific and sensitive. Positive urine culture identifies infecting organism. Enables modification of treatment based on antibiotic susceptibility.[36]
Result
identification of infecting organism
Investigations to consider
pregnancy test
Test
Screened before treatment if applicable.
Result
positive
Use of this content is subject to our disclaimer