Cytology of the Urine in Healthy Persons and Cytological Reactions in Acute Infections, Especially with Respect to the Presence of Inclusion-Bearing and Giant Cells: A Study with Application of Millipore Procedure and Papanicolaou Staining

Abstract

Urinary cytology was studied in 202 healthy individuals and 701 patients, mainly with acute infectious diseases. Two types of reaction of the epithelium was observed: one of a more general nature and one specific to certain infections. The general cytological reaction was manifested in an increased number of multinucleated, inclusion-free cells and in the occurrence of polygonal giant cells. This reaction was observed in all infections involving fever and in febrile mucocutaneous syndrome. The specific cytological reaction was characterized by an increased number of inclusion-bearing cells and occurrence of spherical giant cells, usually containing inclusions. It was seen in measles, influenza A2, mumps, mononucleosis and serous meningitis; also in parainfluenza- and adenovirus infections, in varicella-zoster and herpes simplex, but not in rubella or hepatitis. Formation of inclusions occurred also in some non-viral infections (mycoplasma, haemolytic streptococci, non-specific urethritis in males). The demonstration of an increased number of inclusions and/or spherical giant cells may be of diagnostic value. Cytological studies may have a special significance for illustration of the question of renal damage of viral origin. An account is given of a patient with nephrosclerosis with persistently high inclusion content and successively increasing haematuria. In 78% of healthy persons inclusion-bearing cells were found in moderate quantity, highest in children, lowest in adolescents, thereafter rising again. Cytological differences were found also between the sexes, both in healthy persons and patients. Females of all ages had a lower content both of multinucleated and of inclusion-bearing cells. The sexual difference may be explained by a demonstrably quicker exfoliation of the female urinary tract epithelium.