Bacteria And White Blood Cells In Urine – Morphology: The size of normal red blood cells varies from 6-9 micrometers. They are round and biconvex. In hypertonic urine, cells appear wrinkled; wrinkled with small spines. In hypotonic urine, cells increase in size and become colorless. Dysmorphic red blood cells can occur as a result of glomerular diseases and appear misshapen, fragmented, and/or protruding. “Ghost cells” is a term used to describe red blood cells that have lysed, leaving an outer membrane.

Disease correlation and clinical significance. Pathological causes of red blood cells in urine include glomerular membrane damage/disease, urinary tract infections, kidney stones, and kidney injury. Non-pathological causes of red blood cells are usually due to menstrual contamination.

Bacteria And White Blood Cells In Urine

Bacteria And White Blood Cells In Urine

Helpful Hints: Red blood cells, yeast and oil droplets look the same and need to be differentiated. To distinguish red blood cells from yeast, acetic acid (1:1) can be added to the urine sediment. The red blood cells will lyse in the presence of acetic acid, but the yeast will remain intact. To distinguish red blood cells from oil droplets, use lipid stains such as Oil Red O or Sudan III.

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Morphology: The size of leukocytes is 10-14 micrometers. The most common white blood cells in urine are neutrophils. Thus, most leukocytes in urine will be granular, with the exception of lymphocytes and monocytes.

Disease correlation and clinical significance. Pathological causes of white blood cells in urine include urinary tract infections, inflammation and glomerular disease. The presence of eosinophils in urine is associated with interstitial nephritis.

Helpful Hints: When distinguishing between white blood cells and red blood cells, white blood cells appear more detailed and “blurred” compared to red blood cells. Also note the size difference: white blood cells are usually larger than red blood cells.

Morphology: Squamous cells are the largest of the cells, measuring 50–100 micrometers in size. The cell is irregular in shape and consists of a nucleus the size of a large red blood cell. The edges of the cell membrane often have a folded, jagged, or wrinkled appearance. Squamous epithelial cells originate from the lower part of the urethra and the outer mucous membrane of the genital organs.

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Helpful Tips: When flat cells are folded, they can resemble plaster. To distinguish gypsum from squamous cells, look for the nucleus; gypsum does not have a nucleus.

Morphology: Transitional epithelial cells are smaller in size than squamous cells but larger than RTE cells and leukocytes. They usually have a centralized nucleus and can have various shapes such as oval, pear-shaped, spherical and caudate. The membrane boundary of transitional epithelial cells is more pronounced and has higher contrast than the boundary of squamous cells. Transitional epithelial cells originate from the upper urethra, bladder, ureter and renal pelvis.

Disease correlation and clinical significance. Pathological causes of transitional epithelial cells in urine include infection, kidney stones, inflammation, and bladder cancer. Nonpathological causes of transitional epithelial cells in the urine are usually associated with catheterization.

Bacteria And White Blood Cells In Urine

Helpful Hints: To distinguish them from flat cells, look for a rounded, clearer cell membrane and smaller size.

Urinary Tract Infection

Morphology: Renal tubular epithelial cells (RTEs) are smaller than squamous and transitional epithelial cells, but are usually larger than leukocytes. They come in a variety of shapes, including round, oval, cuboid and oblong. Many forms have an eccentric nucleus with less cytoplasm than transitional or squamous epithelium. RTE cells originate from nephron tubules; proximal convoluted tubule, loop of Henle, distal convoluted tubule and collecting duct.

Disease correlation and clinical significance. Pathogenic causes of RTE cells in urine include renal tubular damage, ischemic events in the nephron, and viral infections.

Helpful Hints: Use size, amount of cytoplasm, and nuclear position to distinguish RTE from transitional epithelial cell and squamous epithelium. Typically, RTE cells are the smallest of the epithelial cells, having less cytoplasm and an eccentric nucleus. Some RTE cells have a flat edge to their outer membrane, which helps distinguish them from transitional cells.

Morphology: Oval fat bodies are RTE cells containing fat droplets. Because of the fat-containing cells, oval fat cells may show a Maltese cross formation under a polarizing microscope. Fat droplets make oval fat pads highly refractive.

Urinary Tract Infection (uti): Causes, Symptoms & Treatment

Disease correlation and clinical significance. Pathogenic causes of the appearance of oval fat bodies in the urine include nephrotic syndrome and damage to the renal tubules.

Helpful Hints: A sample containing oval-shaped fat pads will usually contain free-floating fat droplets. If oval fat cells are suspected, use lipid stains or polarizing microscopy for confirmation.

Fat droplets are not cellular elements, but they can be seen in combination with oval fat bodies. Fat droplets are lipids consisting of either triglycerides, neutral fats or cholesterol, or a combination of these lipids. Pathological causes of fat droplets in urine include nephrotic syndrome and glomerular damage. Fat droplets appear round, vary in size, and are highly refrangible. Fat droplets look like red blood cells, use lipid stains such as Oil Red O or Sudan III to differentiate. Download this “Bacteria and White Blood Cells in a Urine Sample Under a Microscope” photo now. And search iStock’s library of royalty-free stock images to find more zoomed-in photos available for quick and easy downloading. Item #:gm484377046 $12.00 iStock In Stock

Bacteria And White Blood Cells In Urine

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© 2023 LP. iStock designs are trademarks of LP. Explore millions of high-quality stock photos, illustrations and videos. Many rod-shaped bacteria are shown between larger white blood cells on microscopy of the urine of a person with a urinary tract infection.

Exceptions may include pregnant women, patients who have undergone direct kidney transplantation, young children with significant vesicoureteral reflux, and patients who have undergone urinary tract surgery.

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Up to 10% of women will develop a urinary tract infection within a year, and half of all women will develop at least one infection at some point in their lives.

There is an increased risk of asymptomatic or symptomatic bacteriuria during pregnancy due to physiological changes occurring in the pregnant woman that promote the unwanted growth of pathogens in the urinary tract.

Asymptomatic bacteriuria is bacteriuria without accompanying symptoms of a urinary tract infection, usually caused by the bacterium Escherichia coli.

Bacteria And White Blood Cells In Urine

It is more common in women, older adults, residents of long-term care facilities, and people with diabetes, bladder catheters, and spinal cord injuries.

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Bacteriuria is always observed in people with a long-term Foley catheter. Chronic asymptomatic bacteriuria occurs in 50% of the population undergoing long-term treatment.

There is an association between asymptomatic bacteriuria in a pregnant woman with low birth weight, preterm birth, cystitis, infection of the newborn and fetal death.

Symptomatic bacteriuria is bacteriuria with accompanying symptoms of a urinary tract infection (such as frequent urination, painful urination, fever, back pain, abdominal pain, and blood in the urine) and includes pyelonephritis or cystitis.

Testing for bacteriuria is usually performed in people with symptoms of a urinary tract infection. Certain populations who cannot feel or express symptoms of infection are also tested if they have nonspecific symptoms. For example, confusion or other changes in behavior may be a sign of infection in older adults. Screening for asymptomatic bacteriuria during pregnancy is routine in many countries but is controversial.

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Bacteriuria is suspected when one bacterial species is isolated at a concentration of more than 100,000 colony-forming units per milliliter of urine in clean midstream urine samples.

Urine samples obtained from a woman are at risk of bacterial contamination from vaginal flora. Therefore, the study usually analyzes a second sample to confirm that the woman has asymptomatic bacteriuria. For urine collected by bladder catheterization in women and women, one urine sample containing more than 100,000 colony-forming units of a single species per milliliter is considered diagnostic.

The threshold for a woman to experience UTI symptoms can be as low as 100 colony-forming units of one type per milliliter. However, clinical laboratories typically report bacteria with levels below 10,000 colony-forming units per milliliter as “no growth.”

Bacteria And White Blood Cells In Urine

Although controversial, many countries, including the United States, recommend one-time screening for bacteriuria in mid-pregnancy.

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Exceptions include children who have had urinary tract surgery, children with vesicoureteral reflux, or others with structural abnormalities of the urinary tract.

There is no indication for the treatment of asymptomatic bacteriuria in diabetics, transplant recipients, or patients with spinal cord injury.

Such as an increased risk of diarrhea, the spread of antimicrobial resistance, and Clostridium difficile infection.

Symptomatic bacteriuria is synonymous with urinary tract infection and is usually treated with antibiotics. Common choices include nitrofurantoin and trimethoprim/sulfamethoxazole. When it affects the lower urinary tract, it is known as bladder.

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