Volume 11, Number 05

HYPOSYMPTOMATIC BACTERIURIA Laboratory Approach Acute cystitis represents no problem in clinical diagnosis. Subacute or chronic bacteriuric states without frequency or dysuria are more subtle. Often the patient may complain only of non-specific symptoms such as fatigue and headache. Further, totally asymptomatic infections may lead to later bladder dysfunction. Urine cultures should be performed on all patients with non-specific symptomatology and may in fact prove to be a valuable test to add to routine annual screening of patients.

SUMMER DIARRHEA Causes Every summer brings with a number of cases of diarrhea. Some return from a vacation or a trip with it. Below are the commoner causes of this affliction:

NEUTROPENIA Drugs that often cause this condition Neutropenia is defined as an absolute neutrophil count of less than 2.0 x 109/L. It is usually thought that risk of a serious infection occurs only when the absolute counts falls below 1.0 x 199/L. Antiarrhythmics Procainamide HCL (Pronestyl) Quinidine Antibiotics Semisynthetic penicillins Cephalosporins Sulphonamides Trimethoprim-sulfamethoxazole (especially in AIDS and bone marrow transplant patients) Anticonvulsants Phenytoin (Dilantin) Trimethadione (Tridione) Antihypertensives Methyldopa (Aldomet) Captopril (Capoten) Anti-inflammatory agents Gold compounds Penicillamine (Cuprimine, Depen) Phenylbutazone (Azolid, Butazolidin) Aminopyrine Indomethicin (Indocin, Indo-Lemmon) Antineoplastic and immunosuppressive agents Antithyroid agents Propylthiouracil Methimazole (Tapazole) Psychotropic agents Tricyclic antidepressants Phenothiazines Miscellaneous Cimetidine (Tagamet) Alcohol Thiazides Russin, JR et al. Postgrad Med 1990;88(2):209-216

HYPOGLYCEMIA When is it significant? Hypoglycemia is a common occurrence yet in most cases it is of no significance. To complicate matters, many patients have read or heard about this condition and they tend to fixate on it as a cause of their problems. In order to evaluate hypoglycemia, it is necessary to understand the types. Two main types occur the first of which is postpandrial. this is the commoner type and is usually not significant. It is usually corrected by dietary changes, e.g. frequent small meals and avoidance of high carbohydrate loads. The second type is known as fasting hypoglycemia. As implied, it occurs after a period of fast rather than after a meal. This type is less common and is often associated with a serious underlying condition. Shown below is an outline of these two types along with some causes and relevant tests.

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