A significant degree of bacteriuria has been found in some cases to exist in the absence of leukocytes in the urine and also in the absence of such urologic symptoms as dysuria, frequency, and nocturia. Autopsies disclose the presence of pyelonephritis in cases where it had not been recognized ante mortem. For these reasons it is suggested that there must exist an asymptomatic stage in the history of pyelonephritis, intervening between the acute stage and the chronic end-stage. Recognition of the asymptomatic stage depends on the development of reliable and safe techniques for detecting bacteriuria. It is essential if the termination in hypertension and uremia is to be prevented.
Sanford JP. INAPPARENT PYELONEPHRITIS-THE MISSING LINK?. JAMA. 1959;169(15):1711–1714. doi:10.1001/jama.1959.03000320013003
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