A 52-year-old obese woman is seen by her physician. She complains of perineal itching. A pelvic exam reveals that the woman has a white discharge that is collected and sent for culture and identification. Additionally, the woman is instructed to collect a midstream clean catch urine specimen. The urine is sent to the laboratory for a routine urinalysis and the following results are obtained:
Physical Testing
Yellow, cloudy with no odor
Chemical Testing
Glucose 500 mg/dl
Clinitest 500 mg/dl
Bilirubin negative
Ketones negative
Specific Gravity 1.015
pH 5.0
Protein negative
Urobilinogen normal
Nitrite negative
Leucocyte esterase positive
Microscopic Analysis
RBC 0-2/hpf
WBC 10-15/hpf; seen in clumps
Casts 0-2 hyaline
Epithelial Cells - many Squamous Epithelial cells seen
Bacteria negative
Crystals few urates
Yeast moderate
1. Identify the abnormal findings.
2. What results suggest that the woman has a vaginitis?
3. What is the most likely cause of the vaginitis?
4. What results indicate that the urine was not a midstream clean catch?
5. What is the most likely diagnosis for this woman?
6. How does this diagnosis explain the presence of the glucose in the urine?