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EDITORIALS: Alan R Watson Management of urinary tract infection in children BMJ 2007; 335: 356-357 [Full text]

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Microscopy of fresh urine

Michael G Bamber   (28 August 2007)

Microscopy of fresh urine 28 August 2007
Michael G Bamber, General practitioner Colsterworth Medical Practice, Back Lane, Colsterworth, Grantham, Lincolnshire NG33 5NJ Send response to journal: Re: Microscopy of fresh urine	Professor Watson's editorial is enthusiatically written and referenced and stimulated me to read the index article in the same issue. Watson's mention of the NICE guidance on the management of febrile children nicely draws the reader's attention to the difficulty in making a diagnosis of infections of the urinary tract. Watson notes the problems in microscoping fresh urine, without reference as to whether this is in the clinic, although he notes that "..the technician may have reduced experience when asked to perform microscopy out of hours". NICE guidance clearly assumes the clinician to be above microscopy, with the stern injunction to "Send urine sample for urgent microscopy and culture". In this rural area, the local district general hospital no longer has a bacteriology department and samples for microscopy and culture are sent thirty miles away by courier in the daytime, and by taxi for emergency cases. Dare I guess that Professor Watson is a modern nephrologist with no microscope in his clinic, despite coming from the alma mater of Thomas Addis? What is this drug 'clavulinic acid' mentioned in Professor Watson's editorial? Could it be 'clavulanic acid'?. I think we should be told. Yours faithfully Michael G Bamber Competing interests: possessor of two seldom used microscopes without phase contrast!