Urine microscopy and infection in general practice

To test the value of urine microscopy 100 consecutive specimens were examined in the surgery and the results correlated with the subsequent laboratory culture reports.An assessment of the degree of pyuria was made by low power microscopy of a thick drop of fresh urine. A second specimen was examined under high power for the presence or absence of motile bacilli. The techniques used are described and quantified.The laboratory report was definitive in 88 of the 100 cultures. All the 33 specimens with 10(5) bacteriuria had some degree of pyuria and in 27 (82 per cent) motile bacilli had been found. In the 50 with no significant bacteriuria no motile bacilli had been seen in 38 (76 per cent).In these 88 specimens a diagnosis made in the surgery based entirely on bacterial microscopy would have been correct in 80 per cent, combined with cytological microscopy in 87 per cent, and with the addition of clinical features in 92 per cent.In the remaining 12 cases the laboratory report was inconclusive and would have made no difference to my conclusions.