A 28 year old female presents to her doctor with fever, chills and right upper quadrant abdominal pain. Further testing shows WBC casts indicating that there is kidney involvement.
Labs: Gram negative rods that are motile, do not ferment sorbitol, ferment lactose, utilize acetate as its only source of carbon, and use tryptophan to produce indole. Culture reveals colonies with green sheen on EMB agar.
Discussion: The diagnosis of cystitis by Escherichia coli is made by culturing urine samples. Escherichia coli is a common cause of pyelonephritis as well as cystitis. The presence of WBC casts and also the fever indicates that there is kidney involvement. Therefore the diagnosis is pyelonephritis as opposed to cystitis. The infection is an ascending infection and occurs more often in sexually active young women.
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