Urine cloudiness

Cloudy, murky, or turbid urine reflects the presence of bacteria, mucus, leukocytes or erythrocytes, epithelial cells, fat, or phosphates (in alkaline urine). It’s characteristic of urinary tract infection (UTI), but it can also result from prolonged storage of a urine specimen at room temperature.

History and physical examination

Ask about symptoms of UTI, such as dysuria; urinary urgency or frequency; and pain in the flank, lower back, or suprapubic area. Also ask the patient if he has had recurrent UTIs or recent surgery or treatment involving the urinary tract.

Obtain a urine specimen to check for pus or mucus. (See How to perform the three-glass urine test, page 777.) Using a reagent strip, test for blood, glucose, and pH. Palpate the suprapubic area and flanks for tenderness.

If you note cloudy urine in a patient with an indwelling urinary catheter, especially if he also has a fever, remove the catheter immediately (or change it if the patient must have one in place).

Medical causes

UTI

Cloudy urine is common in UTIs. Other urinary findings include urgency, frequency, hesitancy, hematuria, dysuria, nocturia and, in males, a urethral discharge. Other effects include fever, chills, malaise, nausea and vomiting, bladder spasms, costovertebral angle tenderness, and suprapubic, low back, or flank pain.

Special considerations

Collect urine specimens for urinalysis and culture and sensitivity tests. Increase the patient’s fluid intake, and administer an antibiotic and a urinary anesthetic (such as phenazopyridine). Continue checking the appearance of the patient’s urine to monitor the effectiveness of therapy.

Pediatric pointers

Cloudy urine in children also points to a UTI.

Book Source Details

• Book Title: Professional Guide to Signs & Symptoms (Fifth Edition)
• Author(s): Springhouse
• Year of Publication: 2006
• Copyright Details: Professional Guide to Signs & Symptoms (Fifth Edition), Copyright © 2006 Lippincott Williams & Wilkins.

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Copyright Details: Professional Guide to Signs & Symptoms (Fifth Edition), Copyright © 2008 Williams & Wilkins.

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• Back to symptom: Cloudy vision: Introduction (review 215 causes)
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More About This Book: Title: Professional Guide to Signs & Symptoms (Fifth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2006 ISBN: 1-58255-510-9

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