Background Urinary tract infections (UTIs) are usually related to the presence of Escherichia coli, a microorganism that adopts an intracellular life-style during the pathogenesis of cystitis. Evidence of the underlying mechanism in urothelial cells from urine samples has been reported. However, intracellular communities have not yet been described in squamous cells in fresh samples stained with Sternheimer-Malbin method, thus, we have provided these descriptions in this case report. Case presentation Number 1 was a male patient with symptoms of UTI, his urinalysis revealed hematuria and nitrites. In the urine sediment, we found urothelial cells with internal endosomes filled with short rods. Case number 2, female patient with recurrent UTI by E. coli, her urinalysis showed positive nitrites, glycosuria, bacteriuria and squamous cells with endosomes filled with short rods. Both patients were positive for E. coli isolation. Conclusions These case reports provide evidence of the presence of intracellular bacterial communities in urothelial and squamous cells (not previously reported) in fresh urine samples stained with Sternheimer-Malbin using brightfield microscopy. The clinical impact and pathogenic mechanisms involved in the invasion of the squamous epithelium need further investigation.

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ResumenObjetivosLa Enfermedad de Fabry es un trastorno hereditario ocasionado por una mutación en el gen que codifica para la α galactosidasa A, lo que ocasiona la acumulación de glicoesfingolípidos en distintos órganos. El diagnóstico oportuno de esta enfermedad es vital para comenzar el tratamiento y evitar la disfunción orgánica debido a la acumulación de lípidos. Por lo anterior, diversos investigadores han analizado la búsqueda de cuerpos y células de mora como una nueva alternativa del diagnóstico, de lo cual a continuación se describe un caso.Caso clínicoPaciente femenino de la tercera edad, sin antecedentes de enfermedades crónicas, y con síntomas compatibles con infección del tracto urinario (disuria, dolor pélvico y polaquiuria). En base a los resultados de laboratorio, se le diagnostico anemia acompañada de una enfermedad renal crónica. En el examen químico del uroanálisis se presentó una microhematuria, acompañada de proteinuria, mismo que fue observado en el sedimento urinario, adicionalmente se observaron partículas lipídicas compatibles con cuerpos de mora.ConclusionesLa identificación de los cuerpos y células de mora en el sedimento urinario es una herramienta sencilla que puede ayudar en el diagnóstico de la enfermedad de Fabry, lo que puede coadyuvar en el tratamiento oportuno de reemplazo enzimático para reducir las afecciones sistémicas.

ObjectivesFabry disease is a hereditary disease caused by a mutation in the α-galactosidase A (GLA) gene resulting in the accumulation of glycosphingolipids in different organs. Timely diagnosis is crucial for the early initiation of treatment to avoid organic dysfunction secondary to lipid accumulation. In view of the above, a number of studies have been performed to assess the role of mulberry bodies as a new diagnostic tool. In this study, we report a case demonstrating the utility of this test.Case presentationWe report the case of a woman of advanced age without a history of chronic disease with symptoms consistent with urinary tract infection (dysuria, pelvic pain, and frequent urination). Based on laboratory test results, a diagnosis of anemia with concomitant chronic kidney disease was established. Urine test revealed microhematuria, proteinuria, urine sediment, and the presence of lipid particles consistent with mulberry bodies.ConclusionsThe identification of mulberry bodies and cells in urine sediment is an easy-to-use tool potentially useful in diagnosing Fabry disease, which may contribute to initiate enzyme replacement therapy in a timely manner and reduce systemic deterioration.