Bile Urine Update
Original post: https://www.reddit.com/r/medlabprofessionals/s/g3alGDLNYr
Bear in mind that we use soft lab, and as such some of the readings were a pain in my ass to try and read/get.
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65 year old female presented to the ER with complaints of urine changing color and smelled "off" from normal. Patient denied any pain, discomfort, or swelling. Body temp was 100.3F when initially evaluated by staff. A UA, drug test, tox screen, Urine Culture, and multiple urine antigen tests were ordered. Patient had no signifigant personal or family medical history prior to this event.
UA showed lower than normal protein levels, a specific gravity of 1.050, bilirubin of 2+, blood of 2+, moderate mucus levels, yeast and bacteria present in significant amounts, Nitrite of 2+, Urobilinogen of 8, and normal glucose.
Drug and tox screen were negative.
Urine culture showed a >100,000 cfu/mL of mixed flora, likely contamination, including a Enterococcus VRE. Culture was not worked up further.
Histoplasma and Blastomyces antigen tests were positive. This is common in our area due to endemic exposure and thus was ruled not diagnostically significant.
The patient had a preliminary ultrasound that showed no abnormalities. A CT scan was ordered, but the patient left against medical advice before it could be conducted. Patient also refused any advised prescriptions. Follow up phone calls showed the patient was still fine and coherent. No further incidents reported.