Acute pyelonephritis and uncomplicated UTI may be differentiated by all of the following Except :
Correct Answer: Organisms in excess of 100,000 cfu/ml
Description: Answer is C (Organisms in excess of 100,000 (CFU/ml) Although acute pyelonephritis is usually associated with organisms in excess of 100,000 CFU/ml, this test cannot be utilized to localize the infection to kidney as such high counts may well be seen in cases of uncomplicated infections of the lower urinary tract. White Blood cell casts : `Presence of white blood cell casts in urine suggest that inflammation is taking in the kidney itself - Heptinstall `Leucocyte casts (WBC casts) are present in urine of some patients with Acute pyelonephritis and the detection of these casts is pathognomic' - Harrisons 6th/1717 Antibody to Tomm Horsfall Protein Tomm Horsfall protein is exclusively produced by cells in the ascending limb of loop of Henle and is normally found in urine. In conditions such as pyelonephritis (secondary to conditions such as obstructive renal disease or severe vesico- uretric reflux) this protein gets deposited in renal interstitium and bowman's space where it stimulates antibody fermation. Antibodies to Tomm Horsfall proteins suggest infection of the upper renal tract (pyelonephritis) - Diagnosis of Genitourinary disease Tests for impaiment of concentrations of urine may be used to differentiates acute pyelonephritis and infection confined to lower urinary tract - Heptinstall
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