A patient with alkaline urine which is cloudy with plenty of pus cells is suffering from infection with ?
**Core Concept**
The question is testing the student's knowledge of the characteristic urinary tract infections (UTIs) caused by specific bacteria. In this case, the presence of alkaline urine with cloudiness and pus cells points towards a particular type of bacterial infection.
**Why the Correct Answer is Right**
Proteus infections are known to cause alkaline urine due to the production of urease by the bacteria. Urease is an enzyme that breaks down urea into ammonia and carbon dioxide, leading to an increase in the pH of the urine, making it alkaline. This is a characteristic feature of Proteus infections. Additionally, Proteus infections often present with cloudiness and pus cells in the urine due to the presence of bacterial colonies and the inflammatory response.
**Why Each Wrong Option is Incorrect**
**Option A:** E. coli is a common cause of UTIs but does not typically cause alkaline urine. It usually produces acidic urine due to the presence of hippurate.
**Option C:** T.B. (Tuberculosis) is a cause of genitourinary tract infection but does not typically present with alkaline urine or cloudiness and pus cells in the urine.
**Option D:** None is incorrect because one of the options provided (B. Proteus) is the correct answer.
**Clinical Pearl / High-Yield Fact**
Remember the "rule of 5" for Proteus infections: 5% of patients with Proteus infections will have a positive urine culture, 5% will have a positive blood culture, and 5% will have a positive culture from a suprapubic aspirate.
**✓ Correct Answer: B. Proteus**