Piuria Estéril

Fabricio Andrés Lasso Andrade

Resumen


La Piuria estéril es una condición altamente frecuente en la población. Reporta una prevalencia del 29,9% en adultos y del 28,8% en niños, con un registro significativamente menor en hombres (12,8%). Se define como la presencia de 10 o más leucocitos por cada mL en una muestra de orina sin centrifugar, leucocitos en tinción Gram, el reporte positivo de prueba de esterasa leucocitaria y 3 o más leucocitos por campo de alto poder en orina centrifugada; en ausencia de bacterias y urocultivo negativo. Se pueden dividir sus causas entre infecciosas y no infecciosas. Dentro de las causas infecciosas, se ha asociado clásicamente con la tuberculosis urogenital causada por el del bacilo Mycobacterium tuberculosis, enfermedad que se reconoce como la segunda forma de tuberculosis extra pulmonar, aunque existen muchas otras infecciones, condiciones sistémicas y estructurales que pueden producir este hallazgo en el uroanálisis. Esto representa un desafío para el clínico, quien debe basar su aproximación diagnóstica en el levantamiento de una adecuada historia clínica y un prolijo examen físico. En ese contexto, la presente revisión narrativa persigue como objetivo dar a conocer las diferentes causas de la Piuria estéril teniente a describir una aproximación clínica para su abordaje diagnóstico.

 

Sterile Pyuria

Abstract

Sterile pyuria is a highly prevalent condition in the population, with a prevalence of 29.9% in adults and 28.8% in children, being significantly lower in men with 12.8%. This condition is defined as the presence of 10 or more leukocytes per mL of a urine sample without centrifugation, Gram stain leukocytes, positive leukocyte esterase test, 3 or more leukocytes per high power field in centrifuged urine; In the absence of bacteria and negative urine culture. Their causes can be divided into infectious and non-infectious. Within the infectious causes, this finding has been classically associated with urogenital tuberculosis caused by that of the bacillus Mycobacterium tuberculosis, representing the second form of extra pulmonary tuberculosis, occurring in up to 20% of cases with pulmonary tuberculosis, although there are many other infections, conditions Systemic and structural factors that can produce this finding in uroanalysis, posing a challenge for the clinician, who must base his diagnostic approach on an adequate clinical history and a thorough physical examination. This narrative review aims to make known the different causes of sterile pyuria and thus describe a clinical approach for its diagnostic approach.


Palabras clave


Piuria, infección del tracto urinario, tuberculosis, tuberculosis urogenital (MESH), Pyuria, urinary tract infection, tuberculosis, urogenital tuberculosis (MESH)

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Referencias


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