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A clear urine specimen on visual inspection cannot totally exclude a diagnosis of urinary tract infection

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QUESTION: Can visual inspection of urine specimen clarity be used to exclude a diagnosis of urinary tract infection (UTI)?


Blinded comparison of visual inspection of urine specimen clarity with standard urinalysis (diagnostic standard).


The emergency department (ED) of a children's hospital in Cincinnati, Ohio, USA.


Convenience sample of 159 previously healthy patients <21 years of age (mean age 5.8 y, 77% girls) who had either a catheterised (44%) or midstream (56%) urine specimen collected for urine culture. Exclusion criteria were referral for evaluation of an abnormal urinalysis or positive urine culture, current antibiotic use, an underlying medical problem requiring repeat catheterisation (eg, neurogenic bladder), inability to obtain 3 ml of urine in excess of that required for the laboratory, or underlying renal or genitourinary …

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  • Source of funding: no external funding.

  • For correspondence: Dr B Bulloch, Children's Hospital, 820 Sherbrook Street, Room 208A, Winnipeg, Manitoba R3A 1S1, Canada. Fax +1 204 787 4807.