Tuberculosis of urinary system

Examination of urine. In the section of symptomatology was already said about the reaction of urine, the presence of protein in it, leukocytes and erythrocytes in tuberculosis of the kidneys. To differentiate Jurii kidney or gallbladder origin (an even number of cells in both portions) from Jurii urethral or prostatic (different degree of pyuria in both portions) in women explore urine received by the catheter, men - piss obtained by dvuhstadialnoj samples.
Bacteriologically you can explore the sediment pay or better daily portion of urine. The method of coloring Zn-staining is used more often than others, as the most simple and accessible. Bakteriostaticeski can detect M. tuberculosis in the urine in 70-80% of patients, provided that they are not treated with anti-TB chemotherapy.
To differentiate from the tubercle Bacillus non-pathogenic or metapathogen acid-fast saprophytes, in particular sticks smegma, use urine culture on a nutrient medium. Culture acid-fast saprophytes grows in 2-3 days, and culture BC-3-4 weeks.
Great importance is the symptom of aseptic piuria: painted drug urine sediment, despite the large number of cells, there is no flora. This phenomenon is explained by the fact that the tubercle Bacillus its toxins and are caused by high acidity of urine creates unfavorable conditions for the development of banal flora, characteristic only for those cases when specific chemotherapy have not been conducted.
If bakteriostaticeski cannot find the tubercle Bacillus, produce crops urine for a pure culture. After treatment urine sediment 8-10% solution of hydrochloric or sulfuric acid, killing banal flora, it is being sown onto culture media. Colony (macroculture) grow 3-4 weeks. To accelerate bacteriological diagnosis is the method of micro cultures: after 3-4 days after sowing urine is produced scraping Wednesday with the subsequent coloring of the drug in BC. As nutrient use blood, divorced in 3-4 times (the method Shkolnikova).
The most sensitive method for laboratory diagnosis is a biological - urine inoculation Guinea pig. At presence in the urine of Mycobacterium tuberculosis gilt dies from miliary TB through 6-8 weeks or kill in 1-2 months for histological examination bodies.