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Teachable Moment
Less Is More
March 2015

Asymptomatic Bacteriuria, What Are You Treating?

Author Affiliations
  • 1University of Colorado, Internal Medicine Residency Program, Aurora
  • 2University of Colorado, Hospital Medicine Group, Department of Medicine, Aurora
JAMA Intern Med. 2015;175(3):344-345. doi:10.1001/jamainternmed.2014.7132

A man in his 80s with a history of interstitial lung disease, deep venous thrombosis treated with warfarin, and chronic venous stasis presented to the emergency department with swelling of his bilateral lower extremities. He had no other symptoms, and his vital signs were normal. As part of the workup, a urinalysis was obtained, the results of which demonstrated pyuria and positive leukocyte esterase. His urine was sent for culture, and in the meantime he was given a dose of ceftriaxone, 1 g intravenously, for a presumed urinary tract infection (UTI). He was subsequently admitted to the hospital for concern of right-sided heart failure complicating his chronic venous stasis.

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