Poster 211 Heterotopic Ossification Complicating Stroke Recovery in Four Patients: A Case Report

Abstract

Participants: 327 persons with SCI presenting for their annual evaluation in 2012 and 2013. Interventions: Using a validated algorithm, each case was classified as asymptomatic bacteriuria (ASB), urinary tract infection (UTI) or neither. Main Outcome Measures: Urinalysis results (levels of pyuria, presence of nitrates, presence of leukocyte esterase) and urine culture results (colony forming unit count and organisms). Results: The patients were predominantly male (95%), white (60%) and used intermittent catheterization (43%). Of the 327 clinic visits, 271 (83%) had a UA obtained, and 249 (76%) had a UC. 171 (69%) of the cultures were positive. 76 (44%) of the cultures grew urease producing organisms. The vast majority (149, 87%) of the positive cultures represented ASB, and 22 cases (13%) represented UTI. Nitrates were positive in 11 (50%) of the UTI cases and 91 (61%) of the ASB cases. Leukocyte esterase was positive in 21 (95%) of the UTI cases and 133 (89%) of the ASB cases. There was no difference in the mean level of pyuria in the ASB and UTI cases (115, SD 311 and 115, SD 148, respectively). Conclusions: Distinguishing between ASB and UTI poses a diagnostic challenge, as the presenting signs and symptoms of UTI in persons with SCI can be non-specific. Urinalysis and urine culture results can be difficult to interpret in the setting of chronic catheter use.