In addition to the culture methods perfomed in commercial laboratories, point-of-care tests (POC tests) are available for the assessment of bacteriuria in dogs and cats. This article provides an overview of the POC tests currently used to detect bacteriuria in veterinary medicine. Manual urine sediment analysis is a cost-effective method for the detection of bacteria, but there is no clear standardization. Devices for automated urine sediment analysis require visual follow-up by the user, which is essential to correctly identify bacteria. RapidBacVet, a lateral flow immunoassay, enables rapid detection of bacteria in the urine - but without the possibility of differentiation. Culture tests allow bacteria to be grown and tested for sensitivity to antibiotics. However, these methods are limited in cases of mixed infections or specific resistance testing. A chromogenic culture test such as UTid+provides rapid diagnosis of bacteriuria, but does not allow for the quantification of bacterial growth. Accutest Uriscreen, a catalase-based rapid test, detects bacteriuria and pyuria with high sensitivity, but requires a large sample volume of urine. This article highlights the strengths and weaknesses of each POC test and describes how these may contribute to more efficient diagnostics and improved treatment selection in small animal practice.

Neisseria mucosa is a Gram-negative diplococcus that usually colonizes the upper respiratory tract and is generally regarded as a commensal organism. It has, nevertheless, been implicated as an opportunistic pathogen in bacteremia, endocarditis, septic arthritis, meningitis, and peritoneal dialysis-associated peritonitis; urinary tract infection (UTI) remains exceptionally rare. We report a UTI caused by N. mucosa in a 24-day-old male neonate with posterior urethral valves (PUVs), who presented with frank pyuria for 10 days. Direct Gram staining of urine revealed Gram-negative diplococci with a coffee-bean morphology, and the organism was recovered in pure culture. Species identification was achieved by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Antimicrobial susceptibility testing by ETEST® showed susceptibility to ceftriaxone and resistance to benzylpenicillin and ciprofloxacin. Treatment with ceftriaxone was associated with a favorable clinical and biological outcome. This case illustrates the opportunistic potential of N. mucosa in neonates with structural urinary tract abnormalities and emphasizes the value of accurate microbiological identification when UTIs occur in an unusual clinical setting.

Renal tuberculosis (RTB) lesions often initially localize to a specific part of the kidney, presenting with minimal clinical symptoms and a very slow disease progression, which makes the condition highly susceptible to misdiagnosis. We report an instructive case from the Second Affiliated Hospital of Zhejiang University School of Medicine, where a patient was ultimately diagnosed with advanced RTB after a 20-year diagnostic odyssey. The patient exhibited atypical clinical symptoms and was repeatedly diagnosed with recurrent urinary tract infection (UTI). Initial urinalysis revealed microscopic hematuria (52 RBCs/μL), pyuria (615 WBCs/μL), and 1 + proteinuria (0.7 g/L). A urine culture tested positive for Escherichia coli. Ultrasound imaging indicated a right renal calculus, and intravenous pyelography demonstrated significantly diminished right renal function. Suspicion for RTB was raised by CT findings and a positive tuberculosis infection T-cell spot (T-SPOT.TB) test. Acid-fast bacilli were consistently detected in two consecutive urine sediment examinations. The diagnosis was ultimately confirmed through metagenomic next-generation sequencing (mNGS) and postoperative pathological examination. This case underscores that the early diagnosis of RTB is challenging and requires a high index of clinical suspicion, comprehensive analysis of manifestations, and the strategic integration of modern diagnostic tools.

Solitary renal cysts are common in elderly individuals and are usually asymptomatic. Cyst infection is rare but should be recognized as a potential complication. We report an 89-year-old woman with an infected solitary renal cyst who presented with atypical symptoms, including only dizziness, anorexia, and malaise, without localizing signs. Laboratory tests showed elevated inflammatory markers and pyuria, and Escherichia coli was isolated from urine. Imaging revealed enlargement and wall thickening of a Bosniak category II right renal cyst with debris-like echoes. She improved with antibiotics alone. Chronic urinary retention due to neurogenic bladder was considered a possible contributing factor to the cyst infection.

Genitourinary tuberculosis (GU-TB) is a rare but significant manifestation of extrapulmonary tuberculosis, particularly among immunocompromised individuals. Diagnosis remains difficult in resource-limited settings where access to culture or advanced imaging is restricted. The World Health Organization recently endorsed the urinary lipoarabinomannan (TB-LAM) assay for early tuberculosis detection in people with advanced HIV. We report the case of a 29-year-old mestizo man from Peru with HIV diagnosed in 2018 who had discontinued antiretroviral therapy (ART) shortly after initiation. He reengaged with the Peruvian healthcare system in July 2025, presenting with persistent systemic symptoms, including night sweats, anorexia, and lower abdominal discomfort. Laboratory studies revealed a CD4 count of 237 cells/μL and a viral load of 1.59 million copies/mL. Urinalysis showed sterile pyuria and microscopic hematuria. Chest radiography revealed no pulmonary involvement. Renal ultrasound demonstrated increased parenchymal echogenicity with partial loss of corticomedullary differentiation. Given his immunosuppressed state and nonspecific presentation, a TB-LAM test was performed and returned positive. A diagnosis of GU-TB was established, and the patient was initiated on first-line anti-tuberculosis therapy with concurrent ART reintroduction. He demonstrated a favorable clinical response without immune reconstitution inflammatory syndrome (IRIS). This case highlights the diagnostic utility of TB-LAM in extrapulmonary TB among HIV-positive patients and underscores the need for clinical vigilance in high-burden, low-resource settings.