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Urinary Tract Infections are commonly seen in urine cytology. The most common infection is bacterial followed by fungal and viral. Normal urine is sterile. When bacteria accumulate in the bladder, there is a natural immune response first characterized by increased numbers of white blood cells known as neutrophils. Bacterial organisms are often seen in conjunction with numerous normal and reactive appearing urothelial cells. Other types of inflammatory cells such as lymphocytes, eosinophils and histeocytes may also be seen. True fungal infections exhibit hyphae and spores in an inflammatory background. In severe cases, the fungus may be refluxed to the kidney and be found embedded in a renal cast matrix. Polyoma virus, of the BK strain is seen increasingly and its significance is of growing importance. The cells may be shed intermittently for extended periods of time. In immunocompromised individuals, the virus may be severe and cause kidney nephritis. It has also been associated with ureteral stenosis. Cytomegalovirus is widely recognized as a potentially serious cause of complications in the lung, spinal fluid, brain and the cause for graft failure in renal transplantation. Other virally infected cells including Herpes simplex, Adenovirus and Human papilloma virus have been reported. Examples of bacterial, fungal and viral urinary tract infections are shown.
Bacterial urinary tract infection. Papanicolaou Stain, 200X magnification.
Fungal urinary tract infection. Papanicolaou Stain, 200X magnification.
Polyoma virus. Papanicolaou Stain, 600X magnification.
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Photomicrographs
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