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Revista Virtual de la Sociedad Paraguaya de Medicina Interna

On-line version ISSN 2312-3893


SANTA CRUZ SEGOVIA, Francisco Vicente et al. Role of semiology in cystitis and acute pyelonephritis: analysis in Internal Medicine patients of the Hospital de Clínicas, Paraguay. Rev. virtual Soc. Parag. Med. Int. [online]. 2020, vol.7, n.1, pp.30-41. ISSN 2312-3893.


Urinary infections are highly frequent in humans.


To describe the semiological, laboratory and microbiological findings in urinary infections, through the presentation of a series of cases.

Material and methods:

Retrospective, observational, cross-sectional study of the medical histories, urine culture and analyses of the urinary sediment of male and female adult patients who attended the outpatient clinic and / or who were admitted to the First Service of Medical from the Hospital de Clínicas (San Lorenzo, Paraguay) with the diagnosis of urinary tract infection, in the period between February 2015 and February 2017.


In the cases of acute pyelonephritis, the most frequent symptoms were fever (80%) and low back pain (46%). In patients with acute cystitis, dysuria prevailed (93%). In both groups there was a history of previous antibiotic therapy most of the time. Diabetes mellitus was the most prevalent comorbidity in acute pyelonephritis (53%). The urinary sediment presented leukocyturia less than 100/field (66%) and less than 50/field in acute cystitis (66%), with positive urine culture in 67% of cases with prevalence of Escherichia coli (60%). In acute cystitis, the majority had negative urine culture (87%).


At the time of the diagnostic-therapeutic management of both entities, the value of the anamnesis and physical examination in the case of cystitis is highlighted. In acute pyelonephritis, in addition to the history and semiological examination data, microbiological and other studies play an important role in the diagnosis.

Keywords : pyelonephritis; cystitis; urinary sediments; medical records; physical exam; signs and symptoms; urological diseases; urinary infections.

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