Legionella pneumophila. You get it by breathing in mist from water that contains the bacteria. Learn more about the symptoms, treatment, and prevention of Legionnaires' disease.
The Legionella bacteria, which causes Legionnaires' disease
Image by CDC/ Sarah Bailey Cutchin; Photo credit: Illustrator: Dan Higgins
Legionnaires' Disease
The Legionella bacteria, which causes Legionnaires' disease
Image by CDC/ Sarah Bailey Cutchin; Photo credit: Illustrator: Dan Higgins
The Legionella bacteria, which causes Legionnaires' disease
This illustration depicted a three-dimensional (3D), computer-generated image, of a group of Gram-negative, Legionella pneumophila, bacteria. The artistic recreation was based upon scanning electron microscopic (SEM) imagery.
Image by CDC/ Sarah Bailey Cutchin; Photo credit: Illustrator: Dan Higgins
Legionnaires' Disease
Legionnaires' disease is a type of pneumonia caused by bacteria. You usually get it by breathing in mist from water that contains the bacteria. The mist may come from hot tubs, showers, or air-conditioning units for large buildings. The bacteria don't spread from person to person.
Symptoms of Legionnaires' disease include high fever, chills, a cough, and sometimes muscle aches and headaches. Other types of pneumonia have similar symptoms. You will probably need a chest x-ray to diagnose the pneumonia. Lab tests can detect the specific bacteria that cause Legionnaires' disease.
Most people exposed to the bacteria do not become sick. You are more likely to get sick if you
Are older than 50
Smoke
Have a chronic lung disease
Have a weak immune system
Legionnaires' disease is serious and can be life-threatening. However, most people recover with antibiotic treatment.
Source: Centers for Disease Control and Prevention
Additional Materials (16)
Legionnaires' Disease: What You Need to Know
Video by Paul Cochrane/YouTube
Legionnaires' Disease: Are You at Risk?
Video by Wall Street Journal/YouTube
Legionnaires' Disease (Legionella pneumonia) - Symptoms and Causes
Video by medXclusive Learning/YouTube
Turning the Tide: The Role of Water Management to Prevent Legionnaires’ Disease
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Legionnaires' disease: What you need to know
Video by Mayo Clinic/YouTube
Legionella, Legionnaires' Disease & Hot Tubs
Video by Paul Cochrane/YouTube
Legionnaires' disease (1991)
Video by Wellcome Library/YouTube
We Were There - Legionnaires
Video by Centers for Disease Control and Prevention (CDC)/YouTube
How Legionnaires Disease is spread
Video by Guardian Air & Water Hygiene/YouTube
What caused the Legionnaires’ disease outbreak in NYC?
Video by PBS NewsHour/YouTube
Prevention of Legionnaires' Disease
Video by 衞生署衞生防護中心, CHP, Department of Health, HKSARG/YouTube
Legionella
Video by ArkitekStudios/YouTube
Legionnaire's Disease? What is it?
Video by Hartford HealthCare/YouTube
Legionella Ecology & Intro to Env Health & Engineering for Outbreaks
Video by Centers for Disease Control and Prevention (CDC)/YouTube
6 Dangerous Diseases Hiding in U.S. Backyards
Video by SciShow/YouTube
Can Hot Tubs Make You Sick?
Video by SciShow/YouTube
3:01
Legionnaires' Disease: What You Need to Know
Paul Cochrane/YouTube
1:16
Legionnaires' Disease: Are You at Risk?
Wall Street Journal/YouTube
1:44
Legionnaires' Disease (Legionella pneumonia) - Symptoms and Causes
medXclusive Learning/YouTube
11:07
Turning the Tide: The Role of Water Management to Prevent Legionnaires’ Disease
Centers for Disease Control and Prevention (CDC)/YouTube
1:34
Legionnaires' disease: What you need to know
Mayo Clinic/YouTube
3:06
Legionella, Legionnaires' Disease & Hot Tubs
Paul Cochrane/YouTube
11:33
Legionnaires' disease (1991)
Wellcome Library/YouTube
1:27:57
We Were There - Legionnaires
Centers for Disease Control and Prevention (CDC)/YouTube
2:02
How Legionnaires Disease is spread
Guardian Air & Water Hygiene/YouTube
4:46
What caused the Legionnaires’ disease outbreak in NYC?
PBS NewsHour/YouTube
2:02
Prevention of Legionnaires' Disease
衞生署衞生防護中心, CHP, Department of Health, HKSARG/YouTube
1:56
Legionella
ArkitekStudios/YouTube
2:26
Legionnaire's Disease? What is it?
Hartford HealthCare/YouTube
14:50
Legionella Ecology & Intro to Env Health & Engineering for Outbreaks
Centers for Disease Control and Prevention (CDC)/YouTube
11:20
6 Dangerous Diseases Hiding in U.S. Backyards
SciShow/YouTube
3:03
Can Hot Tubs Make You Sick?
SciShow/YouTube
What Is Legionnaires’ Disease?
Legionella pneumophila
Image by CDC/ Dr. William B. Cherry
Legionella pneumophila
This photomicrograph depicted the results of an indirect fluorescent antibody (IFA) technique, in this case, to confirm the presence of Legionella pneumophila bacteria in a human lung secretion sample, extracted from a suspected victim of Legionnaires’ disease.
Image by CDC/ Dr. William B. Cherry
What Is Legionnaires’ Disease?
Legionnaires’ disease is a severe type of pneumonia caused by the bacteria Legionella. The species Legionella pneumophila causes most cases, but other species of Legionella can also cause the disease. It is named Legionnaires’ disease because it was first discovered after a pneumonia outbreak among people who attended an American Legion Convention in Philadelphia, Pennsylvania in 1976.
Most people exposed to Legionella do not become sick with Legionnaires' disease. People who do become sick usually develop symptoms within 2 to 10 days after exposure, but it may take longer. The first symptoms may include headache, chills, muscle pains, and a fever that can be 104°F (40°C) or higher. Additional symptoms usually develop 1 to 2 days after the first symptoms and may include coughing, shortness of breath, chest pain, diarrhea, nausea and vomiting, and confusion. While Legionnaires’ disease mainly affects the lungs, it sometimes causes infections in other parts of the body, such as the heart or within body wounds.
A person can become infected from Legionella when they inhale mist or water droplets that contain the bacteria. Sources of exposure may include showers, faucets, whirlpools, grocery store misters, and water droplets passing through ventilation systems in large buildings (such as hotels, office buildings, and hospitals). People who are more susceptible to developing Legionnaires' disease after an exposure include adults over age 50, current or former smokers, and people who have a weakened immune system or a chronic disease. Generally, neither the bacteria nor Legionnaires' disease is spread directly from person to person. While large exposures can result in outbreaks, the disease usually occurs in single, isolated cases.
Legionnaires' disease may be suspected by symptoms. Pneumonia can be confirmed by a chest X-ray. Legionnaires' disease is diagnosed when one of the species of Legionella is found to be the cause of the pneumonia by testing a urine sample (urine culture) or a sample of saliva and mucus that is coughed up (sputum culture). Without treatment, the disease can be fatal. People with the disease who are otherwise healthy usually recover with antibiotics, although they may need to be cared for in a hospital. About 1 in 10 people with Legionnaires’ disease will not survive due to complications such as respiratory failure, kidney failure, or septic shock.
Of note, Legionella can also cause a milder illness called Pontiac fever, which causes flu-like symptoms, but does not cause pneumonia. Pontiac fever typically goes away without specific treatment.
Source: Genetic and Rare Diseases (GARD) Information Center
Additional Materials (4)
Legionella pneumophila
Magnified 5000X, this digitally colorized scanning electron microscopic (SEM) image depicted a large grouping of Legionella pneumophila bacteria. Note the presence of an elongated-rod morphology in some organisms, seen in other images from this series as well. L. pneumophila frequently elongate when grown in broth, when plate-grown cells age, or when refrigerated, as in this case. Usually, L. pneumophila are stout, fat bacilli, which was the morphology displayed by the majority of these organisms. These bacteria originated on a 1 week-old culture plate (+/- 1 day), forming a single colony, at 37oC, on a buffered charcoal yeast extract (BCYE) medium with no antibiotics. The original sample was acid-treated for 15 min, to minimize fungal impurities, which would have inhibited the visualization of these organisms.
Image by CDC/ Margaret Williams, PhD; Claressa Lucas, PhD; Tatiana Travis, BS; Photo credit: Janice Haney Carr
Legionella can grow and spread in many areas of a building
Effective water management programs can reduce the risk for Legionnaires’ disease.
Legionella can make people sick when the germs grow in water and spread in droplets small enough for people to breathe in.
Legionella grows best in warm water that is not moving or that does not have enough disinfectant to kill germs.
Image by Centers for Disease Control and Prevention (CDC)
Legionella can cause Legionnaires’ disease and Pontiac fever, collectively known as legionellosis.
Scientists named the bacteria after an outbreak in Philadelphia in 1976. During that outbreak, many people who went to an American Legion convention got sick with pneumonia (lung infection).
Health departments reported nearly 10,000 cases of Legionnaires’ disease in the United States in 2018.However, because Legionnaires’ disease is likely underdiagnosed, this number may underestimate the true incidence. A recent study estimated that the true number of Legionnaires’ disease cases may be 1.8–2.7 times higher than what is reported.
About one in 10 people who gets sick from Legionnaires’ disease will die.
People can get Legionnaires’ disease or Pontiac fever when they breathe in small droplets of water in the air that contain Legionella.
In general, people do not spread Legionnaires’ disease to other people. However, this may be possible under rare circumstances.
Legionella occurs naturally in freshwater environments, like lakes and streams. It can become a health concern when it grows and spreads in human-made building water systems.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (4)
Depiction of a person with a lung or lower respiratory tract infection
Depiction of a person suffering from a lung or lower respiratory tract infection. The typical symptoms of LRTI have been shown, along with inflammation in air sacs that happens because of it.
Image by https://www.myupchar.com
Legionnaires' Disease: Are You at Risk?
Video by Wall Street Journal/YouTube
6 Dangerous Diseases Hiding in U.S. Backyards
Video by SciShow/YouTube
In the lung interstitium, alveoli air sacs come into contact with the blood vessels and connective tissues of the lung. If you have hypersensitivity pneumonitis, your body’s immune system reacts strongly to certain inhaled substances, causing inflammation especially in the interstitium or interstitial space.
In the lung interstitium, alveoli air sacs come into contact with the blood vessels and connective tissues of the lung. If you have hypersensitivity pneumonitis, your body’s immune system reacts strongly to certain inhaled substances, causing inflammation especially in the interstitium or interstitial space.
Image by National Heart, Lung, and Blood Institute (NIH)
Depiction of a person with a lung or lower respiratory tract infection
https://www.myupchar.com
1:16
Legionnaires' Disease: Are You at Risk?
Wall Street Journal/YouTube
11:20
6 Dangerous Diseases Hiding in U.S. Backyards
SciShow/YouTube
In the lung interstitium, alveoli air sacs come into contact with the blood vessels and connective tissues of the lung. If you have hypersensitivity pneumonitis, your body’s immune system reacts strongly to certain inhaled substances, causing inflammation especially in the interstitium or interstitial space.
National Heart, Lung, and Blood Institute (NIH)
History and Patterns
This historic photograph depicted Centers for Disease Control (CDC) laboratorian George Gorman at left, along side Dr. Jim Feeley, while they were examining culture plates, i.e., Petri dishes, upon which the first environmental isolates of Legionella pneumophils had been grown.
Image by CDC/ Stafford Smith
This historic photograph depicted Centers for Disease Control (CDC) laboratorian George Gorman at left, along side Dr. Jim Feeley, while they were examining culture plates, i.e., Petri dishes, upon which the first environmental isolates of Legionella pneumophils had been grown.
This historic photograph depicted Centers for Disease Control (CDC) laboratorian George Gorman at left, along side Dr. Jim Feeley, while they were examining culture plates, i.e., Petri dishes, upon which the first environmental isolates of Legionella pneumophils had been grown.
Dr. Feely and Mr. Gorman were the creators of a non-selective medium known as “F-G (Feely-Gorman) medium”, which was used to harvest cultures of L. pneumophila early on in the identification of this bacteria, as the pathogen responsible for causing what came to be known as Legionnaires’ disease. In the photograph, Mr. Gorman can be seen working under a negatively-pressurized ventilation hood, while Dr. Feely was checking the plates under a binocular microscope.
Image by CDC/ Stafford Smith
Legionnaires Disease History and Patterns
History
Legionella was discovered after an outbreak in 1976 among people who went to a Philadelphia convention of the American Legion. Those who were affected suffered from a type of pneumonia that eventually became known as Legionnaires’ disease.
The first identified cases of Pontiac fever occurred in 1968 in Pontiac, Michigan, among people who worked at and visited the city’s health department. It wasn’t until Legionella was discovered after the 1976 Legionnaires’ disease outbreak in Philadelphia that public health officials were able to show that Legionella causes both diseases.
Burden and Trends
The number of cases reported to CDC has been on the rise since 2000. Health departments reported nearly 10,000 cases of Legionnaires’ disease in the United States in 2018. However, because Legionnaires’ disease is likely underdiagnosed, this number may underestimate the true incidence. A recent study estimated that the true number of Legionnaires’ disease cases may be 1.8–2.7 times higher than what is reported. More illness is usually found in the summer and early fall, but it can happen any time of year.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (3)
The old Bellevue Stratford Hotel after the hotel closed in 1986, ten years after the disastrous "Legionnaires' Disease" outbreak there
Table at the Hotel atop the Bellevue, Philadelphia, Pennsylvania - The old Bellevue Stratford Hotel after the hotel closed in 1986, ten years after the disastrous "Legionnaires' Disease" outbreak there. Most of the floors of the hotel became condominium units
Image by Carol M. Highsmith
Legionella pneumophila
Magnified 5000X, this digitally colorized scanning electron microscopic (SEM) image depicted a large grouping of Legionella pneumophila bacteria. Note the presence of an elongated-rod morphology in some organisms, seen in other images from this series as well. L. pneumophila frequently elongate when grown in broth, when plate-grown cells age, or when refrigerated, as in this case. Usually, L. pneumophila are stout, fat bacilli, which was the morphology displayed by the majority of these organisms. These bacteria originated on a 1 week-old culture plate (+/- 1 day), forming a single colony, at 37oC, on a buffered charcoal yeast extract (BCYE) medium with no antibiotics. The original sample was acid-treated for 15 min, to minimize fungal impurities, which would have inhibited the visualization of these organisms.
Image by CDC/ Margaret Williams, PhD; Claressa Lucas, PhD; Tatiana Travis, BS; Photo credit: Janice Haney Carr
We Were There - Legionnaires
Video by Centers for Disease Control and Prevention (CDC)/YouTube
The old Bellevue Stratford Hotel after the hotel closed in 1986, ten years after the disastrous "Legionnaires' Disease" outbreak there
Centers for Disease Control and Prevention (CDC)/YouTube
Symptoms
Woman resting in Bed with Fever
Woman resting in Bed with Fever
Legionnaires Disease Signs and Symptoms
People who get sick after being exposed to Legionella can develop two different illnesses, collectively known as legionellosis: Legionnaires’ disease and Pontiac fever.
Legionnaires’ Disease
Legionnaires’ disease is very similar to other types of pneumonia (lung infection), with symptoms that include:
Legionnaires’ disease symptoms are similar to other types of pneumonia and it often looks the same on a chest x-ray.
Cough
Shortness of breath
Fever
Muscle aches
Headaches
Legionnaires’ disease can also be associated with other symptoms such as diarrhea, nausea, and confusion. Symptoms usually begin 2 to 14 days after being exposed to the bacteria, but it can take longer.
If you develop pneumonia symptoms, see a doctor right away. Be sure to mention if you may have been exposed to Legionella, have used a hot tub, spent any nights away from home, or stayed in a hospital in the last two weeks.
Pontiac Fever
Pontiac fever is a milder infection than Legionnaires’ disease. Symptoms are primarily fever and muscle aches. Symptoms can begin between a few hours to 3 days after being exposed to the bacteria and usually last less than a week. Pontiac fever is different from Legionnaires’ disease because someone with Pontiac fever does not have pneumonia.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (5)
Muscle Pain
Image by CDC
Legionella pneumophila
Magnified 5000X, this digitally colorized scanning electron microscopic (SEM) image depicted a large grouping of Legionella pneumophila bacteria. Note the presence of an elongated-rod morphology in some organisms, seen in other images from this series as well. L. pneumophila frequently elongate when grown in broth, when plate-grown cells age, or when refrigerated, as in this case. Usually, L. pneumophila are stout, fat bacilli, which was the morphology displayed by the majority of these organisms. These bacteria originated on a 1 week-old culture plate (+/- 1 day), forming a single colony, at 37oC, on a buffered charcoal yeast extract (BCYE) medium with no antibiotics. The original sample was acid-treated for 15 min, to minimize fungal impurities, which would have inhibited the visualization of these organisms.
Image by CDC/ Margaret Williams, PhD; Claressa Lucas, PhD; Tatiana Travis, BS; Photo credit: Janice Haney Carr
From the seas to the mountains, across prairies and plains, life is nature`s response to water. Every organic life form - from plants to single-cell amoebae to complex organisms such as ourselves - is dependent on water for its creation and survival. We are drawn to water to satisfy needs that can be physical, psychological, and even spiritual. So intimately are we tied to our need for freshwater that our bodies mirror nature`s water cycle, absorbing all that is needed to support life and releasing what is not into the air and ground. We think of freshwater as an easily renewable resource - after all, it just falls from the sky - but in truth the Earth`s clean water is in limited supply. Nearly all the world`s freshwater is either frozen in glaciers or trapped underground, with only 1% immediately accessible in lakes, rivers, and streams.
Image by TheVisualMD
Legionnaires Disease Causes and Common Sources of Infection
Legionella bacteria are found naturally in freshwater environments, like lakes and streams. The bacteria can become a health concern when they grow and spread in human-made building water systems like
Showerheads and sink faucets
Cooling towers (structures that contain water and a fan as part of centralized air cooling systems for buildings or industrial processes)
Hot tubs
Decorative fountains and water features
Hot water tanks and heaters
Large, complex plumbing systems
Home and car air-conditioning units do not use water to cool the air, so they are not a risk for Legionella growth
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (1)
What caused the Legionnaires’ disease outbreak in NYC?
Video by PBS NewsHour/YouTube
4:46
What caused the Legionnaires’ disease outbreak in NYC?
PBS NewsHour/YouTube
How It Spreads
Wooden hot tub on a trailer, Finland.
Image by kallerna/Wikimedia Commons
Wooden hot tub on a trailer, Finland.
Image by kallerna/Wikimedia Commons
How Legionella Spreads
After Legionella grows and multiplies in a building water system, water containing Legionella can spread in droplets small enough for people to breathe in. People can get Legionnaires’ disease or Pontiac fever when they breathe in small droplets of water in the air that contain the bacteria.
Less commonly, people can get sick by aspiration of drinking water containing Legionella. This happens when water accidently goes into the lungs while drinking. People at increased risk of aspiration include those with swallowing difficulties.
In general, people do not spread Legionnaires’ disease and Pontiac fever to other people. However, this may be possible under rare circumstances.
Talk to your doctor or local health department if
You believe you were exposed to Legionella AND
You develop symptoms, such as fever, cough, chills, or muscle aches
Your local health department can determine whether to investigate. Be sure to mention if you spent any nights away from home in the last 14 days.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (1)
Pregnant hot tub
Pregnant woman in a hot tub
Image by Schwangerschaft/Wikimedia
Pregnant hot tub
Schwangerschaft/Wikimedia
People at Increased Risk
Aging
Image by sabinevanerp/Pixabay
Aging
Image by sabinevanerp/Pixabay
Legionnaires' Disease People at Increased Risk
Most healthy people exposed to Legionella do not get sick. People at increased risk of getting sick are:
People 50 years or older
Current or former smokers
People with a chronic lung disease (like chronic obstructive pulmonary disease or emphysema)
People with weak immune systems or who take drugs that weaken the immune system (like after a transplant operation or chemotherapy)
People with cancer
People with underlying illnesses such as diabetes, kidney failure, or liver failure
Source: Centers for Disease Control and Prevention (CDC)
Diagnosis
Legionella pneumophila
Image by CDC/ Margaret Williams, PhD; Claressa Lucas, PhD;Tatiana Travis, BS; Photo credit: Janice Haney Carr
Legionella pneumophila
Magnified 8000X, this digitally colorized scanning electron microscopic (SEM) image depicted a large grouping of Legionella pneumophila bacteria. Note the presence of an elongated-rod morphology in some organisms, seen in other images from this series as well. L. pneumophila frequently elongate when grown in broth, when plate-grown cells age, or when refrigerated, as in this case. Usually, L. pneumophila are stout, fat bacilli, which was the morphology displayed by the majority of these organisms. These bacteria originated on a 1 week-old culture plate (+/- 1 day), forming a single colony, at 37oC, on a buffered charcoal yeast extract (BCYE) medium with no antibiotics. The original sample was acid-treated for 15 min, to minimize fungal impurities, which would have inhibited the visualization of these organisms.
Image by CDC/ Margaret Williams, PhD; Claressa Lucas, PhD;Tatiana Travis, BS; Photo credit: Janice Haney Carr
Legionnaires Disease Diagnosis
Infection with Legionella bacteria can present as two different types of illness: Legionnaires’ disease and Pontiac fever. The two illnesses can be diagnosed with similar tests, but are treated differently.
Legionnaires’ Disease
Diagnosis
People with Legionnaires’ disease have a serious type of pneumonia (lung infection), which can be confirmed by chest x-ray. Doctors typically use two preferred types of tests to see if a patient’s pneumonia is caused by Legionella:
Urine test
Laboratory test that involves taking a sample of sputum (phlegm) or washing from the lung
Pontiac Fever
Diagnosis
Doctors can use a urine or blood test to see if someone has Pontiac fever. However, a negative test doesn’t rule out that someone may have it (this is called a false negative). Doctors most often diagnose Pontiac fever when there are other known cases of Legionella infection that lab tests confirmed. These patients with confirmed Legionnaires’ disease or Pontiac fever may have been exposed to Legionella at the same time or place as other patients with a suspected illness.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (2)
Legionnaires' Disease
Figure. . . Imaging studies of 42-year-old man with severe pneumonia caused by Legionella pneumophila serogroup 11, showing lobar consolidation of the left lower lung lobe, with an air-bronchogram within the homogeneous airspace consolidation. Consensual mild pleural effusion was documented by a chest radiograph (A) and high-resolution computed tomography (B). A week after hospital admission, repeat high-resolution computerized tomography of the chest showed extensive and homogeneous consolidation of left upper and lower lobes, accompanied by bilateral ground-glass opacities (C and D).
Image by Antonella GrottolaComments to Author , Fabio Forghieri, Marisa Meacci, Anna Fabio, Lorena Pozzi, Patrizia Marchegiano, Mauro Codeluppi, Monica Morselli, Leonardo Potenza, Ambra Paolini, Valeria Coluccio, Mario Luppi, Fabio Rumpianesi, and Monica Pec
Legionnaires' disease: What you need to know
Video by Mayo Clinic/YouTube
Legionnaires' Disease
Antonella GrottolaComments to Author , Fabio Forghieri, Marisa Meacci, Anna Fabio, Lorena Pozzi, Patrizia Marchegiano, Mauro Codeluppi, Monica Morselli, Leonardo Potenza, Ambra Paolini, Valeria Coluccio, Mario Luppi, Fabio Rumpianesi, and Monica Pec
1:34
Legionnaires' disease: What you need to know
Mayo Clinic/YouTube
Legionella Tests
Legionella Tests
Also called: Legionnaires' disease testing, Legionellosis testing, Legionella pneumophila Tests
Legionella tests look for legionella bacteria in urine, sputum, or blood. Legionella bacteria can cause a severe form of pneumonia known as Legionnaires' disease. While the disease can be fatal, most cases can be treated successfully with antibiotics.
Legionella Tests
Also called: Legionnaires' disease testing, Legionellosis testing, Legionella pneumophila Tests
Legionella tests look for legionella bacteria in urine, sputum, or blood. Legionella bacteria can cause a severe form of pneumonia known as Legionnaires' disease. While the disease can be fatal, most cases can be treated successfully with antibiotics.
Legionella is a type of bacteria that can cause a severe form of pneumonia known as Legionnaires' disease. Legionella tests look for these bacteria in urine, sputum, or blood. Legionnaires' disease got its name in 1976 after a group of people attending an American Legion convention became ill with pneumonia.
Legionella bacteria can also cause a milder, flu-like illness called Pontiac fever. Together, Legionnaires' disease and Pontiac fever are known as legionellosis.
Legionella bacteria are found naturally in freshwater environments. But the bacteria can make people sick when it grows and spreads in man-made water systems. These include plumbing systems of large buildings, including hotels, hospitals, nursing homes, and cruise ships. The bacteria may then contaminate water sources, such as hot tubs, fountains, and air-conditioning systems.
Legionellosis infections happen when people breathe in mist or small drops of water that contain the bacteria. The bacteria do not spread from person to person. But a disease outbreak can occur when many people are exposed to the same contaminated water source.
Not everyone who is exposed to Legionella bacteria will get sick. You are more likely to develop an infection you are:
Over the age of 50
A current or former smoker
Have a chronic disease such as diabetes or kidney failure
Have a weakened immune system due to a disease such as HIV/AIDS or cancer, or are taking medicines that suppress the immune system
While Pontiac fever usually clears up on its own, Legionnaires' disease can be fatal if not treated. Most people will recover if promptly treated with antibiotics.
Legionella tests are used to find out whether you have Legionnaires' disease. Other lung diseases have symptoms similar to Legionnaires' disease. Getting the right diagnosis and treatment may help prevent life-threatening complications.
You may need this test if you have symptoms of Legionnaires' disease. Symptoms usually show up two to 10 days after exposure to Legionella bacteria and may include:
Cough
High fever
Chills
Headache
Chest pain
Shortness of breath
Fatigue
Nausea and vomiting
Diarrhea
Legionella tests may be done in urine, sputum, or blood.
During a urine test:
You will need to use the "clean catch" method to ensure your sample is sterile. The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
Sputum is a thick type of mucus made in your lungs when you have an infection.
During a sputum test:
A health care provider will ask you to breathe deeply and then cough deeply into a special cup.
Your provider may tap you on the chest to help loosen sputum from your lungs.
If you have trouble coughing up enough sputum, your provider may ask you to breathe in a salty mist that can help you cough more deeply.
During a blood test:
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for a Legionella test.
There is no risk to providing a urine or sputum sample. There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
If your results were positive, it probably means you have Legionnaires' disease. If your results were negative, it may mean you have a different type of infection. It may also mean not enough Legionella bacteria were found in your sample.
If you have questions about your results, talk to your health care provider.
Whether your results were positive or negative, your provider may do others tests to confirm or rule out a diagnosis of Legionnaires' disease. These include:
Chest X-Rays
Gram Stain
Acid Fast Bacillus (AFB) Tests
Bacteria Culture
Sputum Culture
Respiratory Pathogens Panel
182246: Legionella pneumophila Urinary Antigen | LabCorp [accessed on Dec 10, 2018]
LAGU - Clinical: Legionella Antigen, Urine [accessed on Dec 10, 2018]
https://www.cdc.gov/legionella/downloads/fs-legionnaires.pdf [accessed on Dec 10, 2018]
Legionellosis [accessed on Dec 10, 2018]
Legionella Testing [accessed on Dec 10, 2018]
Additional Materials (7)
Legionella pneumophila
Magnified 5000X, this digitally colorized scanning electron microscopic (SEM) image depicted a large grouping of Legionella pneumophila bacteria. Note the presence of an elongated-rod morphology in some organisms, seen in other images from this series as well. L. pneumophila frequently elongate when grown in broth, when plate-grown cells age, or when refrigerated, as in this case. Usually, L. pneumophila are stout, fat bacilli, which was the morphology displayed by the majority of these organisms. These bacteria originated on a 1 week-old culture plate (+/- 1 day), forming a single colony, at 37oC, on a buffered charcoal yeast extract (BCYE) medium with no antibiotics. The original sample was acid-treated for 15 min, to minimize fungal impurities, which would have inhibited the visualization of these organisms.
Image by CDC/ Margaret Williams, PhD; Claressa Lucas, PhD; Tatiana Travis, BS; Photo credit: Janice Haney Carr
Legionella pneumophila
Under a magnification of 43,700X, this transmission electron microscopic (TEM) image was created from a whole preparation of Legionella pneumophila bacteria, which had been negatively stained using uranyl acetate, and grown on bacteriologic medium. It reveals L. pneumophila organisms reproducing, undergoing the process of cell division, as well as delineating the bacterium’s outer envelope.
Image by CDC/ Dr. Francis Chandler
Legionnaires' Disease
Figure. . . Imaging studies of 42-year-old man with severe pneumonia caused by Legionella pneumophila serogroup 11, showing lobar consolidation of the left lower lung lobe, with an air-bronchogram within the homogeneous airspace consolidation. Consensual mild pleural effusion was documented by a chest radiograph (A) and high-resolution computed tomography (B). A week after hospital admission, repeat high-resolution computerized tomography of the chest showed extensive and homogeneous consolidation of left upper and lower lobes, accompanied by bilateral ground-glass opacities (C and D).
Image by Antonella GrottolaComments to Author , Fabio Forghieri, Marisa Meacci, Anna Fabio, Lorena Pozzi, Patrizia Marchegiano, Mauro Codeluppi, Monica Morselli, Leonardo Potenza, Ambra Paolini, Valeria Coluccio, Mario Luppi, Fabio Rumpianesi, and Monica Pec
Legionella pneumophila
This transmission electron microscopic (TEM) image reveals the presence of numerous Legionella pneumophila bacteria, which were multiplying inside a cultured human lung fibroblast. You’ll note that there were multiple intracellular bacilli, including dividing bacilli, that were visible in both longitudinal and transaxial sections.
Image by CDC/ Dr. Edwin P. Ewing, Jr.
The Legionella bacteria, which causes Legionnaires' disease
This illustration depicted a three-dimensional (3D), computer-generated image, of a group of Gram-negative, Legionella pneumophila, bacteria. The artistic recreation was based upon scanning electron microscopic (SEM) imagery.
Image by CDC/ Sarah Bailey Cutchin; Photo credit: Illustrator: Dan Higgins
Antonella GrottolaComments to Author , Fabio Forghieri, Marisa Meacci, Anna Fabio, Lorena Pozzi, Patrizia Marchegiano, Mauro Codeluppi, Monica Morselli, Leonardo Potenza, Ambra Paolini, Valeria Coluccio, Mario Luppi, Fabio Rumpianesi, and Monica Pec
Legionella pneumophila
CDC/ Dr. Edwin P. Ewing, Jr.
The Legionella bacteria, which causes Legionnaires' disease
CDC/ Sarah Bailey Cutchin; Photo credit: Illustrator: Dan Higgins
3:01
Legionnaires' Disease: What You Need to Know
Paul Cochrane/YouTube
1:56
Legionella
ArkitekStudios/YouTube
Sputum Culture
Sputum Culture
Also called: Sputum cytology, Deep cough sputum, Respiratory culture, Bacterial sputum culture, Routine sputum culture
A sputum culture is a test that helps diagnose infections of the lungs or airways. Sputum is a thick mucus made in your lungs. It is not the same as spit or saliva. You may cough up sputum if you have an infection or chronic illness of the respiratory system.
Sputum Culture
Also called: Sputum cytology, Deep cough sputum, Respiratory culture, Bacterial sputum culture, Routine sputum culture
A sputum culture is a test that helps diagnose infections of the lungs or airways. Sputum is a thick mucus made in your lungs. It is not the same as spit or saliva. You may cough up sputum if you have an infection or chronic illness of the respiratory system.
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Use the slider below to see how your results affect your
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Your result is Negative.
If your results were normal, it means no harmful bacteria or fungi were found. A normal sputum sample result is negative for malignancy.
Related conditions
A sputum culture is a test that checks for bacteria or another type of organism that may be causing an infection in your lungs or the airways leading to the lungs. Sputum, also known as phlegm, is a thick type of mucus made in your lungs. If you have an infection or chronic illness affecting the lungs or airways, it can make you cough up sputum.
Sputum is not the same as spit or saliva. Sputum contains cells from the immune system that help fight the bacteria, fungi, or other foreign substances in your lungs or airways. The thickness of sputum helps trap the foreign material. This allows cilia (tiny hairs) in the airways to push it through the mouth and be coughed out.
Sputum can be one of several different colors. The colors can help identify the type of infection you may have or if a chronic illness has become worse:
Clear. This usually means no disease is present, but large amounts of clear sputum may be a sign of lung disease.
White or gray. This may also be normal, but increased amounts may mean lung disease.
Dark yellow or green. This often means a bacterial infection, such as pneumonia. Yellowish-green sputum is also common in people with cystic fibrosis. Cystic fibrosis is an inherited disease that causes mucus to build up in the lungs and other organs.
Brown. This often shows up in people who smoke. It is also a common sign of black lung disease. Black lung disease is a serious condition that can happen if you have long-term exposure to coal dust.
Pink. This may be a sign of pulmonary edema, a condition in which excess fluid builds up in the lungs. Pulmonary edema is common in people with congestive heart failure.
Red. This may be an early sign of lung cancer. It may also be a sign of a pulmonary embolism, a life-threatening condition in which a blood clot from a leg or other part of the body breaks loose and travels to the lungs. If you are coughing up red or bloody sputum, call 911 or seek immediate medical attention.
A sputum culture is most often used to:
Find and diagnose bacteria or fungi that may be causing an infection in the lungs or airways.
See if a chronic illness of the lungs has worsened.
See if treatment for an infection is working.
A sputum culture is often done with another test called a Gram stain. A Gram stain is a test that checks for bacteria at the site of a suspected infection or in body fluids such as blood or urine. It can help identify the specific type of infection you may have.
You may need this test if you have symptoms of pneumonia or another serious infection of the lungs or airways. These include:
Cough which produces a lot of sputum
Fever
Chills
Shortness of breath
Chest pain that gets worse when you breathe deeply or cough
Fatigue
Confusion, especially in older people
Your health care provider will need to get a sample of your sputum. During the test:
A health care provider will ask you to breathe deeply and then cough deeply into a special cup.
Your provider may tap you on the chest to help loosen sputum from your lungs.
If you have trouble coughing up enough sputum, your provider may ask you to breathe in a salty mist that can help you cough more deeply.
If you still can't cough up enough sputum, your provider may perform a procedure called a bronchoscopy. In this procedure, you'll first get a medicine to help you relax, and then a numbing medicine so you won't feel any pain.
Then a thin, lighted tube will be put through your mouth or nose and into the airways.
Your provider will collect a sample from your airway using a small brush or suction.
You may need to rinse your mouth out with water before the sample is taken. If you will be getting a bronchoscopy, you may be asked to fast (not eat or drink) for one to two hours before the test.
There is no risk to providing a sputum sample into a container. If you had a bronchoscopy, your throat may feel sore after the procedure.
If your results were normal, it means no harmful bacteria or fungi were found. If your results were not normal, it may mean you have some kind of bacterial or fungal infection. Your provider may need to do more tests to find the specific type of infection you have. The most common types of harmful bacteria found in a sputum culture include those that cause:
Pneumonia
Bronchitis
Tuberculosis
An abnormal sputum culture result may also mean a flare-up of a chronic condition, such as cystic fibrosis or chronic obstructive pulmonary disease (COPD). COPD is a lung disease that makes it hard to breathe.
If you have questions about your results, talk to your health care provider.
Sputum may be referred to as phlegm or mucus. All terms are correct, but sputum and phlegm only refer to the mucus made in the respiratory system (lungs and airways). Sputum (phlegm) is a type of mucus. Mucus can also be made elsewhere in the body, such as the urinary or genital tract.
Sputum Cytology | LungCancer.net [accessed on Jan 01, 2019]
Sputum cytology in suspected cases of carcinoma of lung (Sputum cytology a poor man's bronchoscopy!) [accessed on Jan 01, 2019]
Sputum examination for early detection of lung cancer [accessed on Jan 01, 2019]
Sputum Cytology [accessed on Jan 01, 2019]
Lung Cancer Screening and Tests: LDCT, Biopsy, Bronchoscopy, and More [accessed on Jan 01, 2019]
Lung disease | womenshealth.gov [accessed on Jan 11, 2019]
009076: Sputum Cytology Series | LabCorp [accessed on Jan 11, 2019]
Sputum Culture and Cytology Study - MidMichigan Health [accessed on Jan 17, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Phlegm
Sputum
Image by Zhangmoon618
Mycobacterium tuberculosis
This illustration depicts a photomicrograph of a sputum specimen, processed using the Ziehl-Neelsen staining method, and revealed the presence of numerous, Mycobacterium tuberculosis bacteria. This bacterium can attack any part of the body, though usually the lungs, causing tuberculosis, and is spread through inhalation of infected sputum from a coughing, or sneezing individual.
Image by CDC
Sputum
Video by MSREducators/YouTube
How to Identify Haemophilus influenzae in a Sputum Culture
Video by Suzanne Clark/YouTube
Staph sputum - Staphylococcus aureus: Gram positive cocci under the microscope (40x) from a sputum sample.
Staph sputum - Staphylococcus aureus: Gram positive cocci under the microscope (40x) from a sputum sample.
Image by Bobjgalindo
Phlegm
Zhangmoon618
Mycobacterium tuberculosis
CDC
4:18
Sputum
MSREducators/YouTube
8:03
How to Identify Haemophilus influenzae in a Sputum Culture
Suzanne Clark/YouTube
Staph sputum - Staphylococcus aureus: Gram positive cocci under the microscope (40x) from a sputum sample.
Bobjgalindo
Chest X-Ray Test
Chest X-Ray Test
Also called: CXR, Chest X Ray, Chest Radiograph, Chest Radiography, Chest Film
A chest X-ray is an imaging test that uses electromagnetic waves to create pictures of the structures in and around the chest. The test can help diagnose and monitor conditions of the heart, lungs, bones, and chest cavity.
Chest X-Ray Test
Also called: CXR, Chest X Ray, Chest Radiograph, Chest Radiography, Chest Film
A chest X-ray is an imaging test that uses electromagnetic waves to create pictures of the structures in and around the chest. The test can help diagnose and monitor conditions of the heart, lungs, bones, and chest cavity.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
X rays are electromagnetic waves. They use ionizing radiation to create pictures of the inside of your body. A chest x ray takes pictures of the inside of your chest. The different tissues in your chest absorb different amounts of radiation. Your ribs and spine are bony and absorb radiation well. They normally appear light on a chest x ray. Your lungs, which are filled with air, normally appear dark.
Related conditions
A chest x ray is a painless, noninvasive test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. "Noninvasive" means that no surgery is done and no instruments are inserted into your body. This test is done to find the cause of symptoms such as shortness of breath, chest pain, chronic cough (a cough that lasts a long time), and fever.
Chest x rays help doctors diagnose conditions such as pneumonia (nu-MO-ne-ah), heart failure, lung cancer, lung tissue scarring, and sarcoidosis (sar-koy-DO-sis). Doctors also may use chest x rays to see how well treatments for certain conditions are working. Also, doctors often use chest x rays before surgery to look at the structures in the chest.
Chest x rays are the most common x-ray test used to diagnose health problems.
Doctors may recommend chest x rays for people who have symptoms such as shortness of breath, chest pain, chronic cough (a cough that lasts a long time), or fever. The test can help find the cause of these symptoms.
Chest x rays look for conditions such as pneumonia, heart failure, lung cancer, lung tissue scarring, or sarcoidosis. The test also is used to check how well treatments for certain conditions are working.
Chest x rays also are used to evaluate people who test positive for tuberculosis (tu-ber-kyu-LO-sis) exposure on skin tests.
Sometimes, doctors recommend more chest x rays within hours, days, or months of an earlier chest x ray. This allows them to follow up on a condition.
People who are having certain types of surgery also may need chest x rays. Doctors often use the test before surgery to look at the structures inside the chest.
Depending on your doctor's request, you'll stand, sit, or lie for the chest x ray. The technician will help position you correctly. He or she may cover you with a heavy lead apron to protect certain parts of your body from the radiation.
The x-ray equipment usually consists of two parts. One part, a box-like machine, holds the x-ray film or a special plate that records the picture digitally. You'll sit or stand next to this machine. The second part is the x-ray tube, which is located about 6 feet away.
Before the pictures are taken, the technician will walk behind a wall or into the next room to turn on the x-ray machine. This helps reduce his or her exposure to the radiation.
Usually, two views of the chest are taken. The first is a view from the back. The second is a view from the side.
For a view from the back, you'll sit or stand so that your chest rests against the image plate. The x-ray tube will be behind you. For the side view, you'll turn to your side and raise your arms above your head.
If you need to lie down for the test, you'll lie on a table that contains the x-ray film or plate. The x-ray tube will be over the table.
You'll need to hold very still while the pictures are taken. The technician may ask you to hold your breath for a few seconds. These steps help prevent a blurry picture.
Although the test is painless, you may feel some discomfort from the coolness of the exam room and the x-ray plate. If you have arthritis or injuries to the chest wall, shoulders, or arms, you may feel discomfort holding a position during the test. The technician may be able to help you find a more comfortable position.
When the test is done, you'll need to wait while the technician checks the quality of the x-ray pictures. He or she needs to make sure that the pictures are good enough for the doctor to use.
You don't have to do anything special to prepare for a chest x ray. However, you may want to wear a shirt that's easy to take off. Before the test, you'll be asked to undress from the waist up and wear a gown.
You also may want to avoid wearing jewelry and other metal objects. You'll be asked to take off any jewelry, eyeglasses, and metal objects that might interfere with the x-ray picture. Let the x-ray technician (a person specially trained to do x-ray tests) know if you have any body piercings on your chest.
Let your doctor know if you're pregnant or may be pregnant. In general, women should avoid all x-ray tests during pregnancy. Sometimes, though, having an x ray is important to the health of the mother and fetus. If an x ray is needed, the technician will take extra steps to protect the fetus from radiation.
Chest x rays have few risks. The amount of radiation used in a chest x ray is very small. A lead apron may be used to protect certain parts of your body from the radiation.
The test gives out a radiation dose similar to the amount of radiation you're naturally exposed to over 10 days.
Chest x rays show the structures in and around the chest. The test is used to look for and track conditions of the heart, lungs, bones, and chest cavity. For example, chest x-ray pictures may show signs of pneumonia, heart failure, lung cancer, lung tissue scarring, or sarcoidosis.
Chest x rays do have limits. They only show conditions that change the size of tissues in the chest or how the tissues absorb radiation. Also, chest x rays create two-dimensional pictures. This means that denser structures, like bone or the heart, may hide some signs of disease. Very small areas of cancer and blood clots in the lungs usually don't show up on chest x rays.
For these reasons, your doctor may recommend other tests to confirm a diagnosis.
https://www.nhlbi.nih.gov/health-topics/chest-x-ray [accessed on Aug 25, 2021]
https://medlineplus.gov/ency/article/003804.htm [accessed on Aug 25, 2021]
https://www.radiologyinfo.org/en/info/chestrad [accessed on Aug 25, 2021]
https://www.emedicinehealth.com/chest_x-ray/article_em.htm [accessed on Aug 25, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (50)
Chest X-Ray Basics in 5 min
Video by Nick Smith/YouTube
How X-rays see through your skin - Ge Wang
Video by TED-Ed/YouTube
What causes Acute respiratory distress syndrome (ARDS) and who is at Risk?
Chest X-ray of transfusion-related acute lung injury (TRALI syndrome) compared to chest X-ray of the same subject afterwards.
Image by Altaf Gauhar Haji, Shekhar Sharma, DK Vijaykumar and Jerry Paul
Tuberculosis X-ray
An anteroposterior X-ray of a patient diagnosed with advanced bilateral pulmonary tuberculosis. This AP X-ray of the chest reveals the presence of bilateral pulmonary infiltrate (white triangles), and caving forma.
Image by CDC / Der Lange
Respiratory Syncytial Virus
This highly-magnified, 1981 transmission electron microscopic (TEM) image, reveals some of the morphologic traits exhibited by a human respiratory syncytial virus (RSV). The virion is variable in shape, and size, with an average diameter between 120-300nm. RSV is the most common cause of bronchiolitis and pneumonia among infants and children, under 1-year of age.
Image by CDC/ E. L. Palmer
Q Fever Pneumonia X-ray
Combination of two x-rays (A) normal chest x-ray (B) x-ray documenting Q fever pneumonia.
Image by US Gov
Chest X Ray
A Lateral Chest X-Ray with the heart shadow outlined.
Image by US Army
Projectional radiography
Image relating focal spot size to geometric unsharpness in projectional radiography.
Image by Source images by Blausen Medical and LadyofHats (Mariana Ruiz Villarreal) Derivative by Mikael Haggstrom
Chest Radiograph
Chest X-Ray : Specialized test, like a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan, may be needed to confirm the presence of an aneurysm.
Image by TheVisualMD
X-ray of Healthy Lung
This image shows an x-ray of healthy lungs.
Image by TheVisualMD
Cancer screening
Cancer Imaging: X-Rays : Chest X-rays can be used to show the presence of tumors, as for lung cancer, but they may also indicate problems associated with cancer. An X-ray may produce images suggestive of fluid accumulation, masses, or enlarged lymph nodes.
Image by TheVisualMD
Lung Cancer
Chest X-ray (Cancer): This is an x-ray image of a chest. Both sides of the lungs are visible with a growth on the left side of the lung, which could possibly be lung cancer.
Image by National Cancer Institute
Chest X Ray
Mediastinal structures on a chest radiograph.
Image by Mikael Haggstrom, from source images by ZooFari, Stillwaterising and Gray's Anatomy creators
CT Chest Scan of Pleura effusion
CT scan of chest showing loculated pleural effusion in left side. Some thickening of pleura is also noted. From my personal collection. Permission obtained from patient.
Image by Drriad
Chest X-ray (Cancer)
This is an x-ray image of a chest. Both sides of the lungs are visible with a growth on the left side of the lung, which could possibly be lung cancer.
Image by National Cancer Institute / Unknown Photographer
This browser does not support the video element.
CT Scans (VIDEO)
This video shows how modern science of scanning can expose the health condition of the patient. The video starts with a patient undergoing CT scanning, an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. Visible are the heart, lungs, and arteries of a patient.
Video by TheVisualMD
Chest X-Ray
Air-filled trachea and lungs Diaphragmatic domes Mediastinal structures Vascular markings
Arrows indicate costophrenic angles
Image by US Army
Gallstones
Gallstones as seen on plain x-ray.
Image by James Heilman, MD
Hemoptysis x-ray
Hemoptysis can be discovered with the help of radiology.
Image by Aidan Jones from Oxford, U.K.
X-ray of Lung with Pulmonary Edema
Within the lungs, the main airways (bronchi) branch off into smaller passageways, the smallest of which are called bronchioles. At the end of the bronchioles are tiny air sacs (alveoli). Pulmonary edema is a condition caused when excess fluid collects in these air sacs, making it difficult to breathe. Fluid in the lungs can be caused by pneumonia, acute respiratory distress and other conditions, but in most cases, the cause of pulmonary edema is heart problems (when a damaged heart can't pump enough blood and fluid leaks into the lungs).
Image by TheVisualMD
What To Expect During and After Implantable Cardioverter Defibrillator Surgery
A normal chest X-ray after placement of an ICD, showing the ICD generator in the upper left chest and the ICD lead in the right ventricle of the heart. Note the 2 opaque coils along the ICD lead.
Image by Gregory Marcus, MD, MAS, FACC
This browser does not support the video element.
Chest X-ray: NCI B-roll [video]
NCI B-roll of a patient receiving a Chest X-ray. This video is silent.
Video by National Cancer Institute (NCI)
X-Ray of Aneurysm within Chest frontal view
Most aneurysms are detected in the course of an exam, such as a physical exam or a chest X-ray, being performed for a different reason.
Image by TheVisualMD
Pleural Effusion: Tests
Pleural effusion Chest x-ray of a pleural effusion. The arrow A shows fluid layering in the right pleural cavity. The B arrow shows the normal width of the lung in the cavity. A pleural effusion: as seen on chest X-ray. The A arrow indicates fluid layering in the right chest. The B arrow indicates the width of the right lung. The volume of the lung is reduced because of the collection of fluid around the lung.Pleural effusion Chest x-ray of a pleural effusion. The arrow A shows fluid layering in the right pleural cavity. The B arrow shows the normal width of the lung in the cavity. A pleural effusion: as seen on chest X-ray. The A arrow indicates fluid layering in the right chest. The B arrow indicates the width of the right lung. The volume of the lung is reduced because of the collection of fluid around the lung.
Image by CDC InvictaHOG
Coccidioidomycosis
This anteroposterior (AP) chest x-ray revealed pulmonary changes indicative of pulmonary fibrosis in a case of coccidioidomycosis, caused by fungal organisms of the genus, Coccidioides. Because these changes also resemble those seen in other lung infections including tuberculosis, the findings uncovered with a chest x-ray needs to be coupled with serologic testing, as well as possible tissue biopsy. The degree of fibrotic changes, indicative of scarring found on x-ray, can be directly correlated to the severity of the fungal infection.
Image by CDC/ Dr. Lucille K. Georg
How Is Acute respiratory distress syndrome (ARDS) Diagnosed?
Chest X-Ray: Acute respiratory distress syndrome on plain Xray
Image by James Heilman, MD
How Are Asbestos-Related Lung Diseases Diagnosed?
Early Asbestosis in a Retired Pipe Fitter : Chest X-ray in asbestosis shows plaques above diaphragm
Image by Clinical Cases
Aspergillosis
This was a photomicrograph of a lung tissue specimen, harvested from a caged, sulfur-crested cockatoo, that depicted some of the histopathologic changes that had been caused by the fungal organism, Aspergillus fumigatus, in a case of avian pulmonary aspergillosis. Here, you are able see how the periodic acid-Schiff (PAS) stain, revealed A. fumigatus ultrastructural morphology including conidial heads and mycelium.
Image by CDC/ Dr. William Kaplan
Pleural Effusion - Defined
A large left sided pleural effusion as seen on an upright chest X-ray
Image by Drriad
Pleural Effusion: Tests
A large left sided pleural effusion as seen on an upright chest X-ray
Image by James Heilman MD
Breast implants
Chest X-ray showing breast implants
Image by James Heilman
Living With Idiopathic Pulmonary Fibrosis
No cure is available for idiopathic pulmonary fibrosis (IPF) yet. Your symptoms may get worse over time. As your symptoms worsen, you may not be able to do many of the things that you did before you had IPF.
However, lifestyle changes and ongoing care can help you manage the disease.
If you're still smoking, the most important thing you can do is quit. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Ask family members and friends not to smoke in front of you or in your home, car, or workplace.
Image by Drriad
Symptoms and Spread of SARS (Severe acute respiratory syndrome)
A chest x-ray showing increased opacity in both lungs, indicative of pneumonia, in a patient with SARS.
Image by CDC
Chilaiditi syndrome
Chest X-ray showing obvious Chilaiditi's sign, or presence of gas in the right colic angle between the liver and right hemidiaphragm (left side of the image).
Piper's Sign: In days gone by the lateral chest x-ray (demonstrating greater opacity in the aortic arch and descending aorta than the thoracic spine) gave an indication to the degree of calcified plaque burden a patient had. This has been known as Piper's sign and can often be seen in elderly persons particularly those with concomitant osteoporosis.
Image by U4077905
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Image by Stockholm
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Image by Lange123 at German Wikipedia
Chest X-ray in influenza and Haemophilus influenza
Chest X-ray of a 76 year old woman, who developed cough and labored breathing. First testing showed influenza B virus, and later a nasopharyngeal swab detected Haemophilus influenzae. The H influenzae presumably developed as an opportunistic infection secondary to the flu. This X-ray was taken 2 weeks after cultures and start of antibiotics, showing delayed pneumonic infiltrates that were only vaguely visible on initial (not shown) X-rays.
Image by Mikael Häggström
Chest X-ray in influenza and Haemophilus influenzae, lateral
Chest X-ray of a 76 year old woman, who developed cough and labored breathing. First testing showed influenza B virus, and later a nasopharyngeal swab detected Haemophilus influenzae. The H influenzae presumably developed as an opportunistic infection secondary to the flu. This X-ray was taken 2 weeks after cultures and start of antibiotics, showing delayed pneumonic infiltrates that were only vaguely visible on initial (not shown) X-rays.
Image by Mikael Häggström
Fungal Parasites and Pathogens
(a) Ringworm presents as a red ring on skin; (b) Trichophyton violaceum, shown in this bright field light micrograph, causes superficial mycoses on the scalp; (c) Histoplasma capsulatum is an ascomycete that infects airways and causes symptoms similar to influenza. (credit a: modification of work by Dr. Lucille K. Georg, CDC; credit b: modification of work by Dr. Lucille K. Georg, CDC; credit c: modification of work by M. Renz, CDC; scale-bar data from Matt Russell)
Image by CNX Openstax
This anteroposterior (AP) chest x-ray revealed radiologic evidence of pulmonary pneumocystosis in the form of bilateral pulmonary interstitial infiltrates. This infection was due to the presence of an opportunistic fungal infection by the fungal organism Pneumocystis jirovecii, formerly known as Pneumocystis carinii. (This image was provided by Jonathan W.M. Gold. M.D., Assoc. Dir. Special Microbiology Lab, Assist. Attending Physician, Memorial Sloan-Kettering Cancer Center and Assist. Prof. of Medicine, Cornell Univ. Med. College, New York.)
Pneumocystis jirovecii is the causative agent of Pneumocystis pneumonia (PCP), one of the most frequent and severe opportunistic infections in immunocompromised patients. Pneumocystis organisms represent a large group of species of atypical fungi with universal distribution and pulmonary tropism, and each species has a strong specificity for a given mammalian host species.
Image by CDC/ Jonathan W.M. Gold, MD
Chest X-ray PA inverted and enhanced
Chest X-ray PA inverted and enhanced
Image by Stillwaterising
Chest X-Ray of Canadian dollar coin in esophagus of child
PA view Chest X-Ray of Canadian dollar coin in esophagus of child. Released per permission of mother.
Image by Samir (talk)
Chest X Ray
Structures shown: Air-filled trachea and lungs Diaphragmatic domes Mediastinal structures Vascular markings. Arrows indicate costophrenic angles
Image by US Army
Thoracic diaphragm
X-ray of chest, showing top of diaphragm.
Image by OpenStax College
Chest X Ray
Roentgenogram or Medical X-ray image. May not be to scale.
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Stockholm
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Lange123 at German Wikipedia
Chest X-ray in influenza and Haemophilus influenza
Mikael Häggström
Chest X-ray in influenza and Haemophilus influenzae, lateral
Mikael Häggström
Fungal Parasites and Pathogens
CNX Openstax
This anteroposterior (AP) chest x-ray revealed radiologic evidence of pulmonary pneumocystosis in the form of bilateral pulmonary interstitial infiltrates. This infection was due to the presence of an opportunistic fungal infection by the fungal organism Pneumocystis jirovecii, formerly known as Pneumocystis carinii. (This image was provided by Jonathan W.M. Gold. M.D., Assoc. Dir. Special Microbiology Lab, Assist. Attending Physician, Memorial Sloan-Kettering Cancer Center and Assist. Prof. of Medicine, Cornell Univ. Med. College, New York.)
CDC/ Jonathan W.M. Gold, MD
Chest X-ray PA inverted and enhanced
Stillwaterising
Chest X-Ray of Canadian dollar coin in esophagus of child
A chest computed tomography (CT) scan is an imaging test that takes detailed pictures of the lungs and the inside of the chest. Computers combine the pictures to create a 3-D model showing the size, shape, and position of the lungs and structures in the chest.
A chest computed tomography (CT) scan is an imaging test that takes detailed pictures of the lungs and the inside of the chest. Computers combine the pictures to create a 3-D model showing the size, shape, and position of the lungs and structures in the chest.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A chest CT scan provides detailed pictures of the size, shape, and position of your lungs and other structures in your chest. A normal chest CT means your chest appears normal.
Related conditions
A chest CT scan is a more detailed type of chest X-ray. This painless imaging test takes many detailed pictures, called slices, of your lungs and the inside of your chest. Computers can combine these pictures to create three-dimensional (3D) models to help show the size, shape, and position of your lungs and structures in your chest.
This imaging test is often done to follow up on abnormal findings from earlier chest x rays. A chest CT scan also can help determine the cause of lung symptoms such as shortness of breath or chest pain, or check to see if you have certain lung problems such as a tumor, excess fluid around the lungs that is known as pleural effusion, pulmonary embolism, emphysema, tuberculosis, and pneumonia.
A chest CT scan provides detailed pictures of the size, shape, and position of your lungs and other structures in your chest. Doctors use this test to:
Follow up on abnormal results from standard chest x rays.
Find the cause of lung symptoms, such as shortness of breath or chest pain.
Find out whether you have a lung problem, such as a tumor, excess fluid around the lungs, or a pulmonary embolism (a blood clot in the lungs). The test also is used to check for other conditions, such as tuberculosis, emphysema, and pneumonia.
Your doctor may recommend a chest CT scan if you have symptoms of lung problems, such as chest pain or trouble breathing. The scan can help find the cause of the symptoms.
A chest CT scan looks for problems such as tumors, excess fluid around the lungs, and pulmonary embolism (a blood clot in the lungs). The scan also checks for other conditions, such as tuberculosis, emphysema, and pneumonia.
Your doctor may recommend a chest CT scan if a standard chest x ray doesn't help diagnose the problem. The chest CT scan can:
Provide more detailed pictures of your lungs and other chest structures than a standard chest x ray
Find the exact location of a tumor or other problem
Show something that isn't visible on a chest x ray
Your chest CT scan may be done in a medical imaging facility or hospital. The CT scanner is a large, tunnel-like machine that has a table. You will lie still on the table and the table will slide into the scanner. Talk to your doctor if you are uncomfortable in tight or closed spaces to see if you need medicine to relax you during the test. You will hear soft buzzing or clicking sounds when you are inside the scanner and the scanner is taking pictures. You will be able to hear from and talk to the technician performing the test while you are inside the scanner. For some diagnoses, a contrast dye, often iodine-based, may be injected into a vein in your arm before the imaging test. This contrast dye highlights areas inside your chest and creates clearer pictures. You may feel some discomfort from the needle or, after the contrast dye is injected, you may feel warm briefly or have a temporary metallic taste in your mouth.
Wear loose-fitting, comfortable clothing for the test. Sometimes the CT scan technician (a person specially trained to do CT scans) may ask you to wear a hospital gown. You also may want to avoid wearing jewelry and other metal objects. You'll be asked to take off any jewelry, eyeglasses, and metal objects that might interfere with the test. You may be asked to remove hearing aids and dentures as well. Let the technician know if you have any body piercing on your chest.
Tell your doctor whether you're pregnant or may be pregnant. If possible, you should avoid unnecessary radiation exposure during pregnancy. This is because of the concern that radiation may harm the fetus.
Chest CT scans have some risks. In rare instances, some people have an allergic reaction to the contrast dye. There is a slight risk of cancer, particularly in growing children, because the test uses radiation. Although the amount of radiation from one test is usually less than the amount of radiation you are naturally exposed to over three years, patients should not receive more CT scans than the number that clinical guidelines recommend. Another risk is that chest CT scans may detect an incidental finding, which is something that doesn’t cause symptoms but now may require more tests after being found.
Talk to your doctor and the technicians performing the test about whether you are or could be pregnant. If the test is not urgent, they may have you wait to do the test until after your pregnancy. If it is urgent, the technicians will take extra steps to protect your baby during this test. Let your doctor know if you are breastfeeding because contrast dye can pass into your breast milk. If you must have contrast dye injected, you may want to pump and save enough breast milk for one to two days after your test or you may bottle-feed your baby for that time.
https://www.nhlbi.nih.gov/health-topics/chest-ct-scan [accessed on Aug 25, 2021]
https://medlineplus.gov/ency/article/003788.htm [accessed on Aug 25, 2021]
Additional Materials (50)
Pleural empyema
CT chest showing large right sided hydro-pneumothorax from pleural empyema. Arrows A: air, B: fluid
Image by Amit Banga, GC Khilnani, SK Sharma1, AB Dey, Naveet Wig and Namrata Banga
How Are Pleurisy and Other Pleural Disorders Diagnosed?
CT with the identification of underlying lung lesion: an apical bulla.
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Right-sided pneumothorax (right side of image) on CT scan of the chest with chest tube in place.
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Chest Radiograph
Chest X-Ray : Specialized test, like a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan, may be needed to confirm the presence of an aneurysm.
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3D reconstruction of the thin multislice CT, covering human heart and lungs
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Open-chest bypass surgery requires the surgeon to make an incision down the center of the chest, along the breastbone. The rib cage is spread open to expose the heart.
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Coronary CT angiography of coronary arteries
Researchers have found that anti-inflammatory biologic therapies used to treat moderate to severe psoriasis can significantly reduce coronary inflammation in patients with the chronic skin condition. Scientists said the findings are particularly notable because of the use of a novel imaging biomarker, the perivascular fat attenuation index (FAI), that was able to measure the effect of the therapy in reducing the inflammation.
The study published online in JAMA Cardiology, has implications not just for people with psoriasis, but for those with other chronic inflammatory diseases, such as lupus and rheumatoid arthritis. These conditions are known to increase the risk for heart attacks and strokes. The study was funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
In this image: Coronary CT angiography image of the coronary arteries depicting the perivascular fat attenuation index before and after biologic therapy at one-year follow-up for patients with excellent response to biologic therapy.
Image by Oxford Academic Cardiovascular CT Core Lab and Lab of Inflammation and Cardiometabolic Diseases at NHLBI
Coronary CT
Coronary CT
Image by Bác sĩ Nguyễn Minh Đức
CT of the blood vessels and heart
CT of the blood vessels and heart
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Chest CT showing pulmonary sequestration
chest CT: diagnosis is pulmonary sequestration
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Scimitar syndrome chest CT
Scimitar syndrome chest CT
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/Wikimedia
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What to Expect from a CT Exam with Contrast
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CT Scan of the Chest Explained Clearly - High Resolution CT Scan (HRCT)
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Real look at Chest, Abdomen and Pelvis CT Scan from Start to Finish.
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What is it like to get a CT Scan with Contrast?
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Thorax with Healthy Heart
3D visualization based on scanned human data of a healthy heart in the thorax.
Image by TheVisualMD
Heart and Lungs
The heart and lungs are the primary contents of the thorax. They are interconnected with very large blood vessels. The heart sends oxygen-poor blood through the pulmonary arteries to the lungs, which oxygenate it and return it to the heart through the pulmonary veins. The pulmonary arteries arise from one large pulmonary trunk, and then begin branching exponentially once they enter the lungs in order to reach the functional respiratory units and pick up oxygen. The smallest pulmonary veins then take the oxygenated blood backwards through the lungs and empty into the back of the heart through four larger pulmonary veins. The oxygen-rich blood is then pumped by the heart out into the body through the aorta. Deoxygenated blood from body tissues returns to the heart through the superior and inferior vena cava and the cardiac cycle repeats continuously. The pulmonary veins and arteries are the only case where arteries carry deoxygenated blood and veins carry blood that has been oxygenated.
Image by TheVisualMD
Thorax with Muscle Involved in Respiration
3D visualization of an anterior view of the muscles involved in respiration. The primary job of the thorax is to promote movements necessary for breathing. Three muscles of the thorax assist in this function; the external intercostals, internal intercostals and diaphragm. The intercostals do the job of lifting the ribs up and pulling them outward, which in turn enlarges the lungs. As the lungs expand, the pressure inside them is reduced, and they suck in air. During extreme inhalation, the neck muscles also contract. During inhalation, the diaphragm contracts and pushes downward; during exhalation, it relaxes and is pushed up into a dome shape by the lower digestive organs, compressing the lungs. As pressure rises in the chest cavity, exhale occurs, pressure is equalized and the cycle restarts.
Image by TheVisualMD
Thorax with Muscle Involved in Respiration
3D visualization of an inferior view of the muscles involved in respiration. The primary job of the thorax is to promote movements necessary for breathing. Three muscles of the thorax assist in this function; the external intercostals, internal intercostals and diaphragm. The intercostals do the job of lifting the ribs up and pulling them outward, which in turn enlarges the lungs. As the lungs expand, the pressure inside them is reduced, and they suck in air. During extreme inhalation, the neck muscles also contract. During inhalation, the diaphragm contracts and pushes downward; during exhalation, it relaxes and is pushed up into a dome shape by the lower digestive organs, compressing the lungs. As pressure rises in the chest cavity, exhalation occurs, pressure is equalized and the cycle restarts.
Image by TheVisualMD
Thorax with visible Lung and Heart
3D visualization of a posterior view of the lungs and heart reconstructed from scanned human data. De-oxygenated red blood cells are sent by the right side of the heart through the pulmonary artery into the vessels of the lungs to be refilled with oxygen for their next circuit through the body. The blood is carried through the lung tissues, where it exchanges its carbon dioxide for oxygen in the alveoli. It is then returned through the pulmonary veins to the left side of the heart and sent out to the rest of the body. The pulmonary artery carries away the deoxygenated blood, which returns fully oxygenated through the pulmonary vein.
Image by TheVisualMD
Female Thorax Showing Breast
Visualization based on scanned human data of an anterior view of female breast.
Image by TheVisualMD
Male Thorax with Visible Heart
Visualization of male heart. The nerve supply of the heart is emphasized specifically the cardiac plexus. The plexus which rest around the base of the heart, mainly in the epicardium, is formed by cardiac branches from the vagus nerves and the sympathetic trunks and ganglia.
Image by TheVisualMD
Thorax with Heart and Lung
3D visualization of an anterior view of the lungs and heart reconstructed from scanned human data. The cone-shaped lungs occupy most of the thoracic cavity. Each lung is suspended in its own pleural cavity and connected to the mediastinum (which houses the heart) by its root which is made up of vascular and bronchial attachments. The anterior, lateral and posterior surfaces of the lung are in close contact with the ribs and form a continuously curving surface called the costal surface. De-oxygenated red blood cells are sent by the right side of the heart through the pulmonary artery into the vessels of the lungs to be refilled with oxygen for their next circuit through the body. The blood is carried through the lung tissues, where it exchanges its carbon dioxide for oxygen in the alveoli. It is then returned through the pulmonary veins to the left side of the heart and sent out to the rest of the body. The pulmonary artery carries away the deoxygenated blood, which returns fully oxygenated through the pulmonary vein.
Image by TheVisualMD
Cross Section of Human Thorax. Liver in bottom Left
Cross Section of Human Thorax. Liver in bottom Left
Image by TheVisualMD
Male Thorax Showing Trachea and Lung
3D visualization of an anterior view of the lungs and heart reconstructed from scanned human data. De-oxygenated red blood cells are sent by the right side of the heart through the pulmonary artery into the vessels of the lungs to be refilled with oxygen for their next circuit through the body. The blood is carried through the lung tissues, where it exchanges its carbon dioxide for oxygen in the alveoli. It is then returned through the pulmonary veins to the left side of the heart and sent out to the rest of the body. The pulmonary artery carries away the deoxygenated blood, which returns fully oxygenated through the pulmonary vein.
Image by TheVisualMD
Thoracic Aneurysm in the Aorta
Aneurysms that occur in the part of the aorta that is higher in the chest are called thoracic aortic aneurysms. Aortic aneurysms often grow slowly and usually without any symptoms therefore making them difficult to detect
Image by TheVisualMD
Ventilation/perfusion scan
subFusion processing applied to a SPECT lung ventilation-perfusion scan.
Image by KieranMaher at English Wikibooks
Bronchi and Bronchiole of Lung
3D visualization of an inferior view of a transverse section of the thorax, highlighting the lungs, reconstructed from scanned human data. The trachea, cardiac impression, and transverse sections of the thoracic aorta and esophagus are clearly illustrated. The bronchial tree is also visible. When air is inhaled into the lungs, it flows through large tubes called bronchi, branches into smaller tubes known as bronchioles, and ends up in the thousands of small pouches that are the alveoli. This is where the oxygen is transferred from the air into the bloodstream. Each alveolar sac, or air sac, is surrounded by a bed of capillaries, and the walls between the lung and the capillary are extremely thin. The walls are so delicate, in fact, that the inhaled oxygen can seep from the air sacs to bind to the hemoglobin in the blood, while the carbon dioxide and other waste gasses leave the blood and diffuse into the lungs where they can be exhaled.
Image by TheVisualMD
Chest Pain
Angina
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CT scanner
A view of the CT scanner in the new Fort Belvoir Community Hospital. The hospital, still under construction, is a 2005 Base Realignment and Closure project, and is scheduled to open later this year.
Image by Official Navy Page from United States of America MC2 Todd Frantom/U.S. Marine Corps
Illustration of 3 X-ray images and a patient entering a CT scanner
Radiation can be dangerous, but it can also save lives. When you’re faced with a medical test that uses radiation, don’t let fear get in your way. Learn about the risks and benefits, and know what questions to ask.
Image by NIH News in Health
Drawing of a computerized tomography scanner with a health care professional looking on a computer screen as a patient lies inside the scanner
CT scan.
Image by NIDDK Image Library
Advanced CT Scanning
An NIH Clinical Center study participant receives a scan in the Photon-Counting CT scanner.
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Sensitive content
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CAT Scan
A computer-assisted tomographic (CAT) scanner, with a Caucasian female technician working at a screen and behind a glass wall. A patient is on a table and being tested by the CAT scanner. The lighting is very subdued. This new technology revolutionized detection of brain tumors.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Virtual Colonoscopy Slice of CT Data
Virtual colonoscopy is a new imaging technology that uses computed tomography (CT) images to look for polyps and cancer in the colon. A computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Pleural empyema
Amit Banga, GC Khilnani, SK Sharma1, AB Dey, Naveet Wig and Namrata Banga
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Robertolyra
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en:User:Clinical Cases
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TheVisualMD
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Semnic
Incision for Open-Chest Bypass Surgery
TheVisualMD
4:22
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The Royal Children's Hospital Melbourne/YouTube
1:50
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Oxford Academic Cardiovascular CT Core Lab and Lab of Inflammation and Cardiometabolic Diseases at NHLBI
Coronary CT
Bác sĩ Nguyễn Minh Đức
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Bác sĩ Nguyễn Minh Đức
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RadsWiki
Scimitar syndrome chest CT
Matthew Cham, MD
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Cleveland Clinic/YouTube
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TheVisualMD
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TheVisualMD
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TheVisualMD
Thorax with Muscle Involved in Respiration
TheVisualMD
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TheVisualMD
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TheVisualMD
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TheVisualMD
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TheVisualMD
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TheVisualMD
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Bronchoscopy and Bronchoalveolar Lavage
Bronchoscopy and Bronchoalveolar Lavage
Also called: Bronchoscopy, Flexible Bronchoscopy, Bronchoalveolar Lavage, Bronchoalveolar Washing
Bronchoscopy is a procedure that uses a thin tube called a bronchoscope to look at the lungs. Bronchoalveolar lavage is a test that is sometimes done during a bronchoscopy. It is used to collect a fluid sample for testing.
Bronchoscopy and Bronchoalveolar Lavage
Also called: Bronchoscopy, Flexible Bronchoscopy, Bronchoalveolar Lavage, Bronchoalveolar Washing
Bronchoscopy is a procedure that uses a thin tube called a bronchoscope to look at the lungs. Bronchoalveolar lavage is a test that is sometimes done during a bronchoscopy. It is used to collect a fluid sample for testing.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that the large airway leading to the lungs and the breathing tubes in the lungs appear normal. No foreign substances or blockages are seen.
Related conditions
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal or negative result means that the biopsied tissue is normal.
Related conditions
Bronchoscopy is a procedure that allows a health care provider to look at your lungs. It uses a thin, lighted tube called a bronchoscope. The tube is put through the mouth or nose and moved down the throat and into the airways. It helps diagnose and treat certain lung diseases.
Bronchoalveolar lavage (BAL) is a procedure that is sometimes done during a bronchoscopy. It is also called bronchoalveolar washing. BAL is used to collect a sample from the lungs for testing. During the procedure, a saline solution is put through the bronchoscope to wash the airways and capture a fluid sample.
Other names: flexible bronchoscopy, bronchoalveolar washing
Bronchoscopy may be used to:
Find and treat growths or other blockages in the airways
Remove lung tumors
Control bleeding in the airway
Help find the cause of persistent cough
If you've already been diagnosed with lung cancer, the test can help show how severe it is.
Bronchoscopy with BAL is used to collect tissue for testing. These tests help diagnose different disorders of the lungs including:
Bacterial infections such as tuberculosis and bacterial pneumonia
Fungal infections
Lung cancer
One or both tests may be used if an imaging test showed a potential problem with the lungs.
You may need one or both tests if you have symptoms of a lung disease, such as:
Persistent cough
Trouble breathing
Coughing up blood
You may also need a BAL if you have an immune system disorder. Some immune system disorders, such as HIV/AIDS, can put you at higher risk for certain lung infections.
Bronchoscopy and BAL are often done by a pulmonologist. A pulmonologist is a doctor who specializes in diagnosing and treating lung diseases.
A bronchoscopy usually includes the following steps:
You may need to remove some or all of your clothing. If so, you will be given a hospital gown.
You will recline in a chair that is like a dentist's chair or sit on a procedure table with your head raised.
You may get medicine (sedative) to help you relax. The medicine will be injected into a vein or given through an IV (intravenous) line that will be placed in your arm or hand.
Your provider will spray a numbing medicine in your mouth and throat, so you won't feel any pain during the procedure.
Your provider will insert the bronchoscope down your throat and into your airways.
As the bronchoscope is moved down, your provider will examine your lungs.
Your provider may perform other treatments at this time, such as removing a tumor or clearing a blockage.
At this point, you may also get a BAL.
During a BAL:
Your provider will put a small amount of saline through the bronchoscope.
After washing the airways, the saline is sucked up into the bronchoscope.
The saline solution will contain cells and other substances, such as bacteria, which will be taken to a lab for testing.
You may need to fast (not eat or drink) for several hours before your procedure. Your provider will let you know how long you need to avoid food and drink.
You should also arrange to have someone drive you home. If you've been given a sedative, you may be drowsy for a few hours after your procedure.
There is very little risk to having a bronchoscopy or a BAL. The procedures may give you a sore throat for a few days. Serious complications are rare, but they may include bleeding in the airways, infection, or a collapsed part of a lung.
If your bronchoscopy results were not normal, it may mean you have a lung disorder such as:
A blockage, growth, or tumor in the airways
Narrowing of part of the airways
Lung damage due to an immune disorder such as rheumatoid arthritis
If you had BAL and your lung sample results were not normal, it may mean you have lung cancer or a type of infection such as:
Tuberculosis
Bacterial pneumonia
Fungal infection
If you have questions about your results, talk to your health care provider.
In addition to BAL, there are other procedures that can be done during a bronchoscopy. These include:
Sputum culture. Sputum is a thick type of mucus made in your lungs. It is different than spit or saliva. A sputum culture checks for certain types of infections.
Laser therapy or radiation to treat tumors or cancer
Treatment to control bleeding in the lungs
https://www.nhlbi.nih.gov/health-topics/bronchoscopy [accessed on Mar 22, 2019]
https://medlineplus.gov/ency/article/003857.htm [accessed on Mar 22, 2019]
https://www.hopkinsmedicine.org/healthlibrary/test_procedures/pulmonary/bronchoscopy_92,p07743 [accessed on Mar 22, 2019]
https://www.bupa.co.uk/health-information/lungs-breathing/bronchoscopy [accessed on Mar 22, 2019]
https://www.cdc.gov/tb/education/corecurr/pdf/chapter4.pdf#page12 [accessed on Sep 17, 2019]
Additional Materials (20)
Bronchoscopy
Video by Tan Tock Seng Hospital/YouTube
Bronchoscopy - examination of your airways (English version)
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Intro to Bronchoscopy: Risks, indications, contraindications and obtaining consent -- BAVLS
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This media may include sensitive content
Bronchoscopy
Seen is a Caucasian male physician using a bronchoscope which is a flexible tube with a light inside and is inserted into the patient's trachea. Doctors can view inside the body through the tube allowing easier access to removal of tumors.
Image by National Cancer Institute / Unknown Photographer
Sensitive content
This media may include sensitive content
What To Expect Before, During and After a Bronchoscopy
Diagram showing a bronchoscopy.
Image by Cancer Research UK / Wikimedia Commons
Rigid bronchoscopy
Rigid bronchoscopy
Image by JBARRETO
Small Cell Lung Cancer
There is extensive growth of small cell lung carcinoma on the pleural surface of one lung simulating the appearance of mesothelioma.
Image by Yale Rosen from USA
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This media may include sensitive content
What Does Bronchoscopy Show?
Lung cancer in the left. bronchus as seen with a bronchoscope.
Image by JHeuser
Diagnostic Bronchoscopy
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Robotic bronchoscopy - Mayo Clinic
Video by Mayo Clinic/YouTube
Bronchoscopy Procedure, South West Acute Hospital
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Using a Bronchial Scope for a Bronchoscopy at Christian Hospital in St. Louis, Missouri
Video by Christian Hospital/YouTube
Bronchoscopy & Lung Nodule Biopsy | Fox Chase Cancer Center
Video by Fox Chase Cancer Center/YouTube
All About Bronchoscopy
Video by Singapore General Hospital/YouTube
Bronchoscopic Foreign Body Removal -- BAVLS
Video by American Thoracic Society/YouTube
Sedation for Bronchoscopy (English version)
Video by Longkanker Nederland/YouTube
What happens during a bronchoscopy?
Video by Top Doctors UK/YouTube
Bronchoscopy Patient Journey at the Royal Berkshire Hospital
Video by Royal Berkshire NHS Foundation Trust/YouTube
3:12
Bronchoscopy
Tan Tock Seng Hospital/YouTube
1:58
Bronchoscopy - examination of your airways (English version)
Longkanker Nederland/YouTube
7:31
Intro to Bronchoscopy: Risks, indications, contraindications and obtaining consent -- BAVLS
American Thoracic Society/YouTube
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Bronchoscopy
National Cancer Institute / Unknown Photographer
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What To Expect Before, During and After a Bronchoscopy
Cancer Research UK / Wikimedia Commons
Rigid bronchoscopy
JBARRETO
Small Cell Lung Cancer
Yale Rosen from USA
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What Does Bronchoscopy Show?
JHeuser
3:37
Diagnostic Bronchoscopy
Cleveland Clinic Abu Dhabi/YouTube
7:32
EBUS guide for patients: bronchoscopy technique for chest abnormalities
astrazeneca/YouTube
2:09
Electromagnetic Navigation Bronchoscopy
Gundersen Health System/YouTube
4:43
Robotic bronchoscopy - Mayo Clinic
Mayo Clinic/YouTube
9:06
Bronchoscopy Procedure, South West Acute Hospital
WesternTrust/YouTube
5:31
Using a Bronchial Scope for a Bronchoscopy at Christian Hospital in St. Louis, Missouri
Christian Hospital/YouTube
4:25
Bronchoscopy & Lung Nodule Biopsy | Fox Chase Cancer Center
Fox Chase Cancer Center/YouTube
3:36
All About Bronchoscopy
Singapore General Hospital/YouTube
6:02
Bronchoscopic Foreign Body Removal -- BAVLS
American Thoracic Society/YouTube
2:51
Sedation for Bronchoscopy (English version)
Longkanker Nederland/YouTube
2:18
What happens during a bronchoscopy?
Top Doctors UK/YouTube
7:13
Bronchoscopy Patient Journey at the Royal Berkshire Hospital
Royal Berkshire NHS Foundation Trust/YouTube
Urinalysis Test
Urinalysis Test
Also called: Urine Test
A urine test is used to help diagnose a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. It evaluates many characteristics, macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye). It is a routine exam for your health check-up, before surgery, or when pregnant.
Urinalysis Test
Also called: Urine Test
A urine test is used to help diagnose a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. It evaluates many characteristics, macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye). It is a routine exam for your health check-up, before surgery, or when pregnant.
A urinalysis test consists in the evaluation of the macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye, can be seen through a microscope) characteristics of a urine sample to detect and measure various substances and compounds that the body filter through the kidneys.
Usually, these characteristics are done as a single panel and are not done separately as it had been before. This test can be used to make an overall health evaluation of the urinary tract, but it also helps diagnose and monitor many other conditions.
The structure of the test includes:
Macroscopic aspects:
Color
Appearance
Odor
Chemical examination:
pH
Density
Proteins
Glucose
Urobilinogen
Bilirubin
Leucocytes
Nitrites
Blood
Ketones
Microscopic aspects include:
Blood cells (white and red cells)
Epithelial cells
Bacteria
Crystals or casts
The most common uses of the urine test are:
Overall check up
To monitor pregnant women
If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
To monitor a medical condition, such as diabetes or kidney disease
Drug screening
You will need to give a clean catch urine sample.
This requires following these simple steps;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
Macroscopic findings
Appearance (Clarity): normal urine is typically clear. If the urine seems to be cloudy or with floating particles, it may be indicative of urinary tract infection.
Color: most often shades of yellow. Unusual colors might be because of certain foods, medications or a specific condition.
Odor: normally it is relatively mild and not too noticeable.
Chemical examination
pH: this measures the acidity. Under normal conditions, the urine is acidic with pH levels that range from 4.5 to 8.0
Density (specific gravity): this measures how diluted or concentrated is your urine. Normal urine density is usually from 1.003 to 1.035.
Proteins: urine can have small amounts of proteins; however, finding high protein levels may indicate kidney disease or diabetes mellitus.
Glucose: no glucose should be found in the urine of a healthy individual.
Urobilinogen: normal results range from 0.1 to 1.0 mg/dL.
Bilirubin: no bilirubin should be found in the urine of a healthy individual. Positive findings may suggest liver disease.
Nitrite: no nitrites should be found in the urine of a healthy individual. When positive is highly indicative of urinary tract infection.
Ketones: normally is not found. However, it can be positive if you have been fasting for long periods of time, or if you have diabetes mellitus.
Microscopic aspects
Red blood cells (RBC’s): is not unusual to find RBCs in a urine sample; however, 3 or more red blood cells are regarded as a sign of hematuria (blood loss through urine).
White blood cells (WBC’s): under normal conditions, this parameter should be negative. A positive result is suggestive of urinary tract infection.
Epithelial cells: from 1 to 5 squamous/hpf is considered to be normal. Higher results may indicate contamination of the urine sample by improper collection methods.
Bacteria: it is normal to find up to 1+ bacteria; more than this is abnormal and should be analyzed to discern whether is caused by an infection or by improper sample storage.
Crystals or casts: no crystals or casts should be found in the urine of healthy individuals. When present, it may be indicative of kidney disease or kidney stones.
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
Mayo Clinic: Urinalysis [accessed on Aug 19, 2018]
Urinalysis: A Comprehensive Review; Am Fam Physician. 2005 Mar 15;71(6):1153-1162. [accessed on Aug 19, 2018]
University of Utah: Urinalysis [accessed on Aug 19, 2018]
Additional Materials (22)
Urine Hydration chart
Image by Aishik Rehman/Wikimedia
Test Tube Containing Urine
Visualization of a test tube containing urine. Urine comprises mainly of water - 96% and the remaining 4% is urea and sodium.
Image by TheVisualMD
Urine in Vial
Urine is tested for a variety of reasons and can reveal a wealth of information about the source individual. More than 100 different tests can be done on urine. In addition to visual characteristics, for example color and clarity, urine may be examined for the presence of glucose, nitrites, or ketones. Microscopic examination may reveal the presence of red or white blood cells, or bacteria, yeast cells, or parasites. Urine samples may contain tumor markers, which can suggest cancer.
Image by TheVisualMD
White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)
White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)
Image by Bobjgalindo
Abundant uric acid crystals in a human urine sample
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Struvite crystals (urine)
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Uric acid crystals (urine)
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Urine samples
Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Urine samples are evaluated visually, for color, clarity and concentration; chemically, for various substances, such as glucose and proteins, in solution; and microscopically, for signs of bacteria, crystals and other contaminants.
Image by TheVisualMD
Male Figure with Urinary System
Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.
Image by TheVisualMD
Urine collection container
Image by frolicsomepl/Pixabay
Cancer screening
Screening for Cancer: Urine Tests : Urine samples may contain tumor markers, which can suggest cancer. Urinalysis is commonly a part of routine health screening. It is simply an analysis of the urine that can be performed in many healthcare settings including doctors' offices, urgent care facilities, laboratories, and hospitals. Urinalysis can disclose evidence of diseases, even some that have not caused significant signs or symptoms.
Image by TheVisualMD
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Male Urinary System
Image of a male showing his urinary system. The urinary system, also known as the excretory system, produces, stores, and eliminates urine. It also helps to maintain the fluid balance in humans. The male urinary system consists of two kidneys, ureters, a urinary bladder, prostate, and urethra.
Image by TheVisualMD
Nephron of Kidney
The nephron is composed of looping and folding tubules that at first glance look like an impossibly tangled knot of highways, side roads and interchanges. But in fact, the nephron directs the traffic flow effortlessly. When stretched out, a nephron would be almost a couple of feet in length and there are about a million nephrons in each kidney. A nephron is composed of two basic parts: the glomerulus and the tubule. The glomerulus, part of the vascular system, is a tuft of capillaries that filters the wastes and fluid from the blood. The tubules then catch, concentrate and excrete the waste into the urine. The walls of the tubules are made of specialized cells, which serve as \"check points\" for the waste flowing by them. Hormonal sensors in these cells determine which substances should be excreted as waste and which substances will be reabsorbed into the blood to nourish the body's cells. The specific materials the cells are assigned to reabsorb or secrete include water and essential nutrients, salts and minerals, depending on where in the tubules the cells are located. From the glomerulus until the collecting duct, intricate and minute calculations are at constant play within the nephron. The production of urine does not just result in a waste product but also protects the fine balance of substances required to keep the body healthy.
Image by TheVisualMD
Fluid Filtration
Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of waste, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli. The kidneys also play a key role in maintaining the body's fluid balance within a very narrow range. Even a 1% increase in blood sodium, for example, will make a person thirsty enough to take a drink in order to return the fluid balance to normal.
Image by TheVisualMD
Ammonia, Urine
Ammonia is a waste product generated by intestinal bacteria during the digestion of protein. From the intestine, ammonia is transported to the liver, where it is converted into urea, which is then excreted in the urine by the kidneys. The conversion and elimination of ammonia can be impaired by liver disease or kidney damage, which can result in a dangerous build up of ammonia.
Image by TheVisualMD
Pyuria
Urine may contain pus (a condition known as pyuria) as seen from a person with sepsis due to a urinary tract infection.
Image by James Heilman, MD
Urine
Sample of human urine
Image by Markhamilton
Interpretation of the Urinalysis (Part 1) - Introduction and Inspection
Video by Strong Medicine/YouTube
Interpretation of the Urinalysis (Part 2) - The Dipstick
Video by Strong Medicine/YouTube
How to collect a mid-stream urine sample for a urinary tract infection test
Video by Pathology Tests Explained/YouTube
How to collect a first-void or first-pass urine sample
Video by Pathology Tests Explained/YouTube
Urine Hydration chart
Aishik Rehman/Wikimedia
Test Tube Containing Urine
TheVisualMD
Urine in Vial
TheVisualMD
White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)
Bobjgalindo
Abundant uric acid crystals in a human urine sample
Doruk Salancı
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample
Doruk Salancı
Struvite crystals (urine)
Doruk Salancı
Uric acid crystals (urine)
Doruk Salancı
Urine samples
TheVisualMD
Male Figure with Urinary System
TheVisualMD
Urine collection container
frolicsomepl/Pixabay
Cancer screening
TheVisualMD
Sensitive content
This media may include sensitive content
Male Urinary System
TheVisualMD
Nephron of Kidney
TheVisualMD
Fluid Filtration
TheVisualMD
Ammonia, Urine
TheVisualMD
Pyuria
James Heilman, MD
Urine
Markhamilton
6:10
Interpretation of the Urinalysis (Part 1) - Introduction and Inspection
Strong Medicine/YouTube
16:36
Interpretation of the Urinalysis (Part 2) - The Dipstick
Strong Medicine/YouTube
1:03
How to collect a mid-stream urine sample for a urinary tract infection test
Pathology Tests Explained/YouTube
1:06
How to collect a first-void or first-pass urine sample
A glucose in urine test measures the amount of glucose (sugar) in your urine. The test is used to monitor both type 1 and type 2 diabetes.
{"label":"Glucose in Urine Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":15},"text":"Glucose is not usually found in urine. If it is, further testing is needed. ","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":15,"max":40},"text":"If high levels of glucose in urine are found in pregnant women, it may indicate\u00a0gestational diabetes. A urine glucose test is only a screening test. If glucose is found in your urine, your provider will order a blood glucose test to help make a diagnosis.","conditions":["Diabetes","Pregnancy","Renal glycosuria"]}],"value":7.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
mg/dL
15
Your result is Negative.
Glucose is not usually found in urine. If it is, further testing is needed.
Related conditions
A glucose in urine test measures the amount of glucose in your urine. Glucose is a type of sugar. It is your body's main source of energy. A hormone called insulin helps move glucose from your bloodstream into your cells. If too much glucose gets into the blood, the extra glucose will be eliminated through your urine. A urine glucose test can be used to help determine if blood glucose levels are too high, which may be a sign of diabetes.
A glucose in urine test may be part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. Urinalysis is often included as part of a routine exam. A glucose in urine test may also be used to screen for diabetes. However, a urine glucose test is not as accurate as a blood glucose test. It may be ordered if blood glucose testing is difficult or not possible. Some people can't get blood drawn because their veins are too small or too scarred from repeated punctures. Other people avoid blood tests due to extreme anxiety or fear of needles.
You may get a glucose in urine test as part of your regular checkup or if you have symptoms of diabetes and cannot take a blood glucose test. Symptoms of diabetes include:
Increased thirst
More frequent urination
Blurred vision
Fatigue
You may also need a urinalysis, which includes a glucose in urine test, if you are pregnant. If high levels of glucose in urine are found, it may indicate gestational diabetes. Gestational diabetes is form of diabetes that happens only during pregnancy. Blood glucose testing can be used to confirm a diagnosis of gestational diabetes. Most pregnant women are tested for gestational diabetes with a blood glucose test, between their 24th and 28th weeks of pregnancy.
If your urine glucose test is part of a urinalysis, you will need to provide a sample of your urine. During your office visit, you will receive a container in which to collect the urine and special instructions to ensure the sample is sterile. These instructions are often referred to as the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
Your health care provider may ask you to monitor your urine glucose at home with a test kit. He or she will provide you with either a kit or a recommendation of which kit to buy. Your urine glucose test kit will include instructions on how to perform the test and a package of strips for testing. Be sure to follow the kit instructions carefully, and talk to your health care provider if you have any questions.
You don't need any special preparations for this test.
There is no known risk to having a glucose in urine test.
Glucose is not normally found in urine. If results show glucose, it may be a sign of:
Diabetes
Pregnancy. As many half of all pregnant women have some glucose in their urine during pregnancy. Too much glucose may indicate gestational diabetes.
A kidney disorder
A urine glucose test is only a screening test. If glucose is found in your urine, your provider will order a blood glucose test to help make a diagnosis.
https://medlineplus.gov/lab-tests/glucose-in-urine-test/ [accessed on Sep 15, 2019]
https://medlineplus.gov/ency/article/003581.htm [accessed on Sep 15, 2019]
https://www.labcorp.com/test-menu/26061/glucose-quantitative-urine [accessed on Sep 15, 2019]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=glucose_urine [accessed on Sep 15, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (6)
Abdomen Revealing Pancreas and Kidney
Sugar is one of the nutrients your body uses for energy. It is the product of the body's breakdown of complex carbohydrates and is circulated in the blood to all your cells. Although blood sugar levels change depending on whether you just ate or exercised, in general, your body keeps the sugar levels within a narrow range. Not enough sugar - hypoglycemia - and you can get hungry, shaky, sweaty, tired, and even faint. Too much sugar - hyperglycemia - is a cardiovascular risk factor leading to arteriosclerosis (hardening of the arteries). To control blood sugar levels, your body depends on a hormone called insulin.
Image by TheVisualMD
Diabetes Symptoms
(left to right) Fatigue: dehydration, lack of ability to utilize glucose for energy and other factors cause fatigue; weight loss: because it can't use glucose for energy, the body breaks down muscle instead; constant hunger: diabetes prevents glucose from entering cells, leading to constant hunger due to cell starvation; increased thirst: too much urination leaves tissues dehydrated and causes increased thirst; frequent urination: fluids are drawn from tissues and the kidneys constantly filter out glucose, leading to frequent urination.
Image by TheVisualMD
Male Figure with Urinary System
Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.
Image by TheVisualMD
Kidney Glomeruli, Compromised Filtration
Our kidneys are remarkable filters. Each day, they filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Proteins are also normally filtered out of the blood and recycled in the body by the kidneys. When kidneys are diseased or damaged, however, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
Image by TheVisualMD
Diseased and Aging Kidney Tissue Comparisons
As a person ages, the number of nephrons, the kidneys' vital filters, decreases, as does the overall amount of tissue in the kidneys. A healthy aging kidney will not function like a 20-year-old kidney, but it can still do its job. The difference between an aging kidney in a healthy body and a kidney damaged by hypertension or diabetes can be as stark as the difference between someone who is a picture of health and someone who is debilitated by illness.
Image by TheVisualMD
Glomerulonephritis
Our kidneys filter about 200 quarts of blood each day to extract about 2 quarts of waste, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli. Glomerulonephritis is the inflammation of these tiny filters and can be caused by diabetes and chronic high blood pressure or, in acute cases, infection. When kidney function declines, waste products normally filtered out and excreted into the urine begin instead to accumulate in the blood.
Image by TheVisualMD
Abdomen Revealing Pancreas and Kidney
TheVisualMD
Diabetes Symptoms
TheVisualMD
Male Figure with Urinary System
TheVisualMD
Kidney Glomeruli, Compromised Filtration
TheVisualMD
Diseased and Aging Kidney Tissue Comparisons
TheVisualMD
Glomerulonephritis
TheVisualMD
Bilirubin in Urine Test
Bilirubin in Urine Test
Also called: Total Urine Bilirubin, Bilirubin
Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. When the liver is damaged, bilirubin can leak into your urine. A bilirubin in urine test can help detect liver disease.
Bilirubin in Urine Test
Also called: Total Urine Bilirubin, Bilirubin
Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. When the liver is damaged, bilirubin can leak into your urine. A bilirubin in urine test can help detect liver disease.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Bilirubin is not normally found in the urine.
Related conditions
A bilirubin in urine test measures the levels of bilirubin in your urine. Bilirubin is a yellowish substance made during the body's normal process of breaking down red blood cells. Bilirubin is found in bile, a fluid in your liver that helps you digest food. If your liver is healthy, it will remove most of the bilirubin from your body. If your liver is damaged, bilirubin can leak into the blood and urine. Bilirubin in urine may be a sign of liver disease.
A bilirubin in urine test is often part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. Urinalysis is often included as part of a routine exam. This test may also be used to check for liver problems.
Your health care provider may have ordered a bilirubin in urine test as part of your regular checkup, or if you have symptoms of liver disease. These symptoms include:
Jaundice, a condition that causes your skin and eyes to turn yellow
Dark-colored urine
Abdominal pain
Nausea and vomiting
Fatigue
Because bilirubin in urine can indicate liver damage before other symptoms appear, your health care provider may order a bilirubin in urine test if you are at a higher risk for liver damage. Risk factors for liver disease include:
Family history of liver disease
Heavy drinking
Exposure or possible exposure to hepatitis virus
Obesity
Diabetes
Taking certain medicines that can cause liver damage
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container to your health care provider.
You don't need any special preparations to test for bilirubin in urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a bilirubin in urine test.
If bilirubin is found in your urine, it may indicate:
A liver disease such as hepatitis
A blockage in the structures that carry bile from your liver
A problem with liver function
A bilirubin in urine test is only one measure of liver function. If your results are abnormal, your health care provider may order additional blood and urine tests, including a liver panel. A liver panel is a series of blood tests that measure various enzymes, proteins, and substances in the liver. It is often used to detect liver disease.
Bilirubin in Urine: MedlinePlus Lab Test Information [accessed on Aug 22, 2021]
https://medlineplus.gov/ency/article/003595.htm [accessed on Aug 22, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Ketones in Urine Test
Ketones in Urine Test
Also called: Urine Ketones, Ketone Bodies (Urine), Ketones Urine Test
Ketones in urine may indicate a problem with the body's ability to burn energy. Diabetics are at a higher risk for developing urine ketones. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.
Ketones in Urine Test
Also called: Urine Ketones, Ketone Bodies (Urine), Ketones Urine Test
Ketones in urine may indicate a problem with the body's ability to burn energy. Diabetics are at a higher risk for developing urine ketones. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.
{"label":"Ketones in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"N","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":20},"text":"A negative test result is normal.","conditions":[]},{"flag":"borderline","label":{"short":"S","long":"Small","orientation":"horizontal"},"values":{"min":20,"max":40},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]},{"flag":"abnormal","label":{"short":"M","long":"Moderate","orientation":"horizontal"},"values":{"min":40,"max":60},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]},{"flag":"abnormal","label":{"short":"L","long":"Large","orientation":"horizontal"},"values":{"min":60,"max":80},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]}],"value":10}[{"normal":0},{"borderline":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
A negative test result is normal.
Related conditions
The test measures ketone levels in your urine. Normally, your body burns glucose (sugar) for energy. If your cells don't get enough glucose, your body burns fat for energy instead. This produces a substance called ketones, which can show up in your blood and urine. High ketone levels in urine may indicate diabetic ketoacidosis (DKA), a complication of diabetes that can lead to a coma or even death. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.
The test is often used to help monitor people at a higher risk of developing ketones. These include people with type 1 or type 2 diabetes. If you have diabetes, ketones in urine can mean that you are not getting enough insulin. If you don't have diabetes, you may still be at risk for developing ketones if you:
Experience chronic vomiting and/or diarrhea
Have a digestive disorder
Participate in strenuous exercise
Are on a very low-carbohydrate diet
Have an eating disorder
Are pregnant
Your health care provider may order a ketones in urine test if you have diabetes or other risk factors for developing ketones. You may also need this test if you have symptoms of ketoacidosis. These include:
Nausea or vomiting
Abdominal pain
Confusion
Trouble breathing
Feeling extremely sleepy
People with type 1 diabetes are at a higher risk for ketoacidosis.
A ketones in urine test can be done in the home as well as in a lab. If in a lab, you will be given instructions to provide a "clean catch" sample. The clean catch method generally includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
If you do the test at home, follow the instructions that are in your test kit. Your kit will include a package of strips for testing. You will either be instructed to provide a clean catch sample in a container as described above or to put the test strip directly in the stream of your urine. Talk to your health care provider about specific instructions.
You may have to fast (not eat or drink) for a certain period of time before taking a ketones in urine test. Ask your health care provider if you need to fast or do any other type of preparation before your test.
There is no known risk to having a ketones in urine test.
Your test results may be a specific number or listed as a "small," "moderate," or "large" amount of ketones. Normal results can vary, depending on your on your diet, activity level, and other factors. Because high ketone levels can be dangerous, be sure to talk to your health care provider about what is normal for you and what your results mean.
Ketone test kits are available at most pharmacies without a prescription. If you are planning to test for ketones at home, ask your health care provider for recommendations on which kit would be best for you. At-home urine tests are easy to perform and can provide accurate results as long as you carefully follow all instructions.
Ketones in Urine: MedlinePlus Lab Test Information [accessed on Sep 15, 2019]
https://medlineplus.gov/ency/article/003585.htm [accessed on Sep 15, 2019]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=ketone_bodies_urine [accessed on Sep 15, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
DKA - Diabetic Ketoacidosis
Video by DrER.tv/YouTube
Symptoms of Ketoacidosis
Video by Diabetes.co.uk/YouTube
Diabetes & Associated Complications
Video by Boehringer Ingelheim/YouTube
Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
A medical illustration depicting a ketone urine test
A medical illustration depicting a ketone urine test
Image by BruceBlaus
5:46
DKA - Diabetic Ketoacidosis
DrER.tv/YouTube
1:00
Symptoms of Ketoacidosis
Diabetes.co.uk/YouTube
5:50
Diabetes & Associated Complications
Boehringer Ingelheim/YouTube
11:26
Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
A medical illustration depicting a ketone urine test
BruceBlaus
Urine Specific Gravity Test
Urine Specific Gravity Test
Also called: Urine SG, Specific Gravity of Urine, Urine Density
A urine specific gravity test measures the concentration of solutes in your urine, which shows if your kidneys are properly diluting urine. This test is a partial analysis used in case of suspected kidney disorder.
Urine Specific Gravity Test
Also called: Urine SG, Specific Gravity of Urine, Urine Density
A urine specific gravity test measures the concentration of solutes in your urine, which shows if your kidneys are properly diluting urine. This test is a partial analysis used in case of suspected kidney disorder.
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Use the slider below to see how your results affect your
health.
1.002
1.03
Your result is Normal.
Normal results can slightly vary from laboratory to laboratory.
Related conditions
In the kidneys, most of the water, ions, and nutrients are returned to the body while waste products and excess ions are excreted through the urine.
Normally, the color of urine is straw-yellow but it may be affected by several situations, including infections, intake of certain foods or medications, or insufficient or excessive fluid intake. Your urine color may reflect how concentrated or diluted is your urine.
A urine specific gravity (SG) test is used to compare the density of your urine to the normal density of water. The result gives an overview of the concentration of the solutes (particles) in your urine. In other words, it shows how well your kidneys are diluting urine.
A shift in the urine SG test result may give the first indication that your kidneys are not working properly. However, if a kidney disorder is suspected, further tests should be taken to confirm or exclude certain disease.
A urine specific gravity test is mainly used as a partial analysis to assess the kidney’s ability to concentrate and dilute urine. Thus, it can be used to help detect certain disorders or diseases of the urinary tract.
Your doctor may order a urine specific gravity test as part of your routine health checkup, or to help diagnose or monitor the following conditions:
Urinary tract infection
Dehydration or overhydration
Kidney infection (pyelonephritis)
Kidney failure
Shifts in sodium levels (hypernatremia or hyponatremia)
Diabetes
Shock
Heart failure
Testing for urine specific gravity starts with mid-stream urine sample collection. It is recommended that the sample is collected in the morning when the urine concentration is the highest.
To collect the urine sample, you need to clean your genitals and then discard the first stream of urine into the toilet (this is done to “clean” your urethra), proceeding then to collect about two ounces of midstream urine in the container. You need to be careful not to touch your genitals with the container to avoid possible contamination with external germs. Once you have collected enough urine, put the container cap on and then you can finish emptying your bladder into the toilet.
After the collection, the sample is transported to the laboratory.
Your doctor may ask you to stop taking certain medications and foods before the test.
There are no risks related to a urine gravity test.
The normal value for urine specific gravity is 1.002-1.030.
Lower-than-normal values of urine gravity may indicate:
Higher-than-normal urine gravity test results may refer to an increased level of some substances in your urine, such as proteins, bacteria, glucose, urine crystals, red and white blood cells. These findings may occur in cases of:
Liver disease
Adrenal glands disorder
Heart disease
Dehydration (not consuming enough water, or losing too much fluid through sweating, vomiting, or diarrhea)
Shock
Certain foods may affect the color of your urine; therefore, it's advised not to eat foods such as beet, rhubarb, blackberries, carrots or lava beans before giving a urine sample.
Sometimes doctors may choose a urine osmolality test instead of a urine specific gravity test. The urine osmolarity test is more specific and could help your doctor to diagnose certain disorders more accurately.
https://medlineplus.gov/ency/article/003587.htm [accessed on Oct 09, 2021]
Urine Specific Gravity Test: Overview, Tests, and Procedure [accessed on Oct 29, 2018]
Urine specific gravity test: Procedure and results [accessed on Oct 29, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (20)
Hematuria
Hematuria Trauma : Gross hematuria due to kidney trauma.
Image by James Heilman, MD
Hematuria by anatomic location
Source of Hematuria by anatomic location
Image by Copene
Phenazopyridine
Pyridiumurine : The characteristic color of urine after taking pyridium.
Image by James Heilman, MD
Drawing of a kidney with an inset of a nephron
The glomeruli are sets of looping blood vessels in nephrons--the tiny working units of the kidneys that filter wastes and remove extra fluid from the blood.
Image by NIDDK Image Library
Urine samples
Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Urine samples are evaluated visually, for color, clarity and concentration; chemically, for various substances, such as glucose and proteins, in solution; and microscopically, for signs of bacteria, crystals and other contaminants.
Image by TheVisualMD
Urine in Vial
Urine is tested for a variety of reasons and can reveal a wealth of information about the source individual. More than 100 different tests can be done on urine. In addition to visual characteristics, for example color and clarity, urine may be examined for the presence of glucose, nitrites, or ketones. Microscopic examination may reveal the presence of red or white blood cells, or bacteria, yeast cells, or parasites. Urine samples may contain tumor markers, which can suggest cancer.
Image by TheVisualMD
Ureteropelvic junction obstruction
Drawing of a swollen kidney that results from ureteropelvic junction obstruction. The point of blockage is labeled UPJ obstruction. UPJ obstruction occurs when urine is blocked where the ureter joins the kidney.
Image by NIDDK Image Library
Bilirubin, Jaundice Urine
When damaged or dying red blood cells are broken down, bilirubin, a yellow pigment and component of hemoglobin, is released into the bloodstream. Bilirubin is usually eliminated from the body by the liver as a component of bile, which is released into the small intestine to aid digestion. Under normal circumstances, very little, if any, bilirubin is excreted in the urine, but in cases of liver damage or a blockage of the bile ducts, some bilirubin can leak out and appear in the urine, turning it a darker color.
Image by TheVisualMD
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
Healthy vs Damaged Kidney
A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.
Urine Test for Albumin
If you are at risk for kidney disease, your provider may check your urine for albumin.
Albumin is a protein found in your blood. A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. The less albumin in your urine, the better. Having albumin in the urine is called albuminuria.
A diagram showing a healthy kidney with albumin only found in blood, and a damaged kidney that has albumin in both blood and urine.
A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.
A health care provider can check for albumin in your urine in two ways:
Dipstick test for albumin. A provider uses a urine sample to look for albumin in your urine. You collect the urine sample in a container in a health care provider’s office or lab. For the test, a provider places a strip of chemically treated paper, called a dipstick, into the urine. The dipstick changes color if albumin is present in the urine.
Urine albumin-to-creatinine ratio (UACR). This test measures and compares the amount of albumin with the amount of creatinine in your urine sample. Providers use your UACR to estimate how much albumin would pass into your urine over 24 hours. A urine albumin result of
30 mg/g or less is normal
more than 30 mg/g may be a sign of kidney disease
If you have albumin in your urine, your provider may want you to repeat the urine test one or two more times to confirm the results. Talk with your provider about what your specific numbers mean for you.
If you have kidney disease, measuring the albumin in your urine helps your provider know which treatment is best for you. A urine albumin level that stays the same or goes down may mean that treatments are working.
Image by The National Institute of Diabetes and Digestive and Kidney Diseases/NIH
Drawing of a urine sample and dipstick
A strip of chemically treated paper will change color when dipped in urine with too much protein.
Image by NIDDK Image Library
Struvite crystals (urine)
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Uric acid crystals (urine)
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Male Figure with Urinary System
Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.
Image by TheVisualMD
Adequate water intake and kidney health
Adequate water intake and kidney health. Replacing the water lost through sweating and waste elimination is vital to our health. Remaining hydrated is one way to help prevent kidney stones, which can form when certain waste minerals are highly concentrated in the urine. In this 3-D visualization, a clear bottle pours water into a model of a human kidney.
Image by TheVisualMD
Urine
Sample of human urine
Image by Markhamilton
Urine Culture: Preventing UTIs
There are a number of ways you can help to prevent UTIs. Drinking plenty of liquids, especially water, not only aids your kidneys in filtering out wastes, it also dilutes your urine and makes you urinate more frequently. This flushes out bacteria and other pathogens from your urinary tract and helps to prevent infections. Urinating after having sex also helps to flush out bacteria. Women should wipe from front to back when using the toilet and change tampons and pads frequently during their periods.
Image by TheVisualMD
formation of urine
Anatomy and physiology of animals Summary of the processes involved in the formation of urine.
Image by Sunshineconnelly
male's urinary system
Urinary system in the male. Urine flows from the kidneys via the ureters into the bladder where it is stored. When urinating, urine flows through the urethra (longer in males, shorter in females) to exit the body
Image by BruceBlaus
Urine of patient with porphyria
Change in urine color before and after sun exposure Left figure is urine of the first day. Right figure is urine after sun exposure for 3 days. Urine color changed to “port wine” color after sun exposure. This color change is due to increased concentrations of porphyrin intermediates in the urine, indicating an abnormality in production and a partial block within the enzymatic porphyrin chain with metabolite formation. The urine color usually becomes darker with acute illness, even dark reddish or brown after sun exposure.
Image by Chen GL, Yang DH, Wu JY, Kuo CW, Hsu WH
Hematuria
James Heilman, MD
Hematuria by anatomic location
Copene
Phenazopyridine
James Heilman, MD
Drawing of a kidney with an inset of a nephron
NIDDK Image Library
Urine samples
TheVisualMD
Urine in Vial
TheVisualMD
Ureteropelvic junction obstruction
NIDDK Image Library
Bilirubin, Jaundice Urine
TheVisualMD
Urine Color Chart
OpenStax College
Healthy vs Damaged Kidney
The National Institute of Diabetes and Digestive and Kidney Diseases/NIH
Drawing of a urine sample and dipstick
NIDDK Image Library
Struvite crystals (urine)
Doruk Salancı
Uric acid crystals (urine)
Doruk Salancı
Male Figure with Urinary System
TheVisualMD
Adequate water intake and kidney health
TheVisualMD
Urine
Markhamilton
Urine Culture: Preventing UTIs
TheVisualMD
formation of urine
Sunshineconnelly
male's urinary system
BruceBlaus
Urine of patient with porphyria
Chen GL, Yang DH, Wu JY, Kuo CW, Hsu WH
Blood in Urine Test
Blood in Urine Test
Also called: Hematuria, Bloody urine
A blood in urine test is part of a urinalysis, a test that measures different cells, chemicals, and other substances in urine. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection,
Blood in Urine Test
Also called: Hematuria, Bloody urine
A blood in urine test is part of a urinalysis, a test that measures different cells, chemicals, and other substances in urine. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection,
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Related conditions
A test called a urinalysis can detect whether there is blood in your urine. A urinalysis checks a sample of your urine for different cells, chemicals, and other substances, including blood. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection, or liver disease.
A urinalysis, which includes a test for blood in urine, may be done as part of a regular checkup or to check for disorders of the urinary tract, kidney, or liver.
Your health care provider may have ordered a urinalysis as part of a routine exam. You may also need this test if you have seen blood in your urine or have other symptoms of a urinary disorder. These symptoms include:
Painful urination
Frequent urination
Back pain
Abdominal pain
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." It includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the needed amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations before getting a test for blood in your urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a blood in urine test.
There are a variety of factors that can cause red or white blood cells to be present in the urine. Many are not cause for concern. Small amounts of blood in the urine may be due to certain medicines, intense exercise, sexual activity, or menstruation. If larger amounts of blood are found, your health care provider may request further testing.
Increased red blood cells in urine may indicate:
A viral infection
Inflammation of the kidney or bladder
A blood disorder
Bladder or kidney cancer
Increased white blood cells in urine may indicate:
A bacterial urinary tract infection. This is the most common cause of a high white blood cell count in urine.
Inflammation of the urinary tract or kidneys
To learn what your results mean, talk to your health care provider.
A blood in urine test is usually part of a typical urinalysis. In addition to checking for blood, a urinalysis measures other substances in the urine, including proteins, acid and sugar levels, cell fragments, and crystals.
Lab Tests Online: Blood in Urine (Hematuria) [accessed on Aug 19, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (12)
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
Hematuria (Blood in the Urine)
Video by mdconversation/YouTube
Blood in the Urine: What does it mean?
Video by Frederick Memorial Hospital/YouTube
Blood in the Urine
Video by St. Mark's Hospital/YouTube
Hematuria
Microscopic hematuria
Image by Bobjgalindo
Hematuria
Hematuria Trauma : Gross hematuria due to kidney trauma.
Image by James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Hematuria by anatomic location
Source of Hematuria by anatomic location
Image by Copene
Microphotography - sample of urine with hematuria
Microphotography - sample of urine with hematuria
Image by J3D3
This browser does not support the video element.
Bleeding Tissue
Blood continues to flow into tissue after the piercing needle has left the finger. Camera starts off looking at the cut edges of bleeding capillaries in the tissue and then looks down at the cavity where blood is beginning to pool.
Video by TheVisualMD
Microhematuria
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Phenazopyridine
Pyridiumurine : The characteristic color of urine after taking pyridium.
Image by James Heilman, MD
Urine Color Chart
OpenStax College
12:53
Hematuria (Blood in the Urine)
mdconversation/YouTube
0:50
Blood in the Urine: What does it mean?
Frederick Memorial Hospital/YouTube
2:24
Blood in the Urine
St. Mark's Hospital/YouTube
Hematuria
Bobjgalindo
Hematuria
James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Bobjgalindo
Hematuria by anatomic location
Copene
Microphotography - sample of urine with hematuria
J3D3
0:08
Bleeding Tissue
TheVisualMD
Microhematuria
Bobjgalindo
Phenazopyridine
James Heilman, MD
PH of Urine Test
PH of Urine Test
Also called: Acid Loading Test, Urine pH, Alkaline Urine Test, Acidic Urine Test
A urine pH test is used to detect a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. Any pH higher than 8 is basic or alkaline, and any under 6 is acidic. A urine pH test is carried out as a part of a urinalysis.
PH of Urine Test
Also called: Acid Loading Test, Urine pH, Alkaline Urine Test, Acidic Urine Test
A urine pH test is used to detect a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. Any pH higher than 8 is basic or alkaline, and any under 6 is acidic. A urine pH test is carried out as a part of a urinalysis.
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Use the slider below to see how your results affect your
health.
pH
4.5
8
Your result is Normal.
A normal urine pH range is between 4.5 and 8.0.
Related conditions
A urine pH test is the analysis of the acidity/alkalinity of the urine. It is part of the chemical examination in a urinalysis. This test can be used to make an overall health evaluation of the urinary tract, but it also helps diagnose and monitor many other conditions.
Some of the most common uses of the urine pH test are:
Evaluate the risk of developing kidney stones (nephrolithiasis)
Assessment of metabolic acidosis
Monitor treatment of uric acid kidney stones
Help identify crystals in the urine
You will need to provide a urine sample.
No preparations are required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
Under normal conditions, the urine is acidic with pH levels that range from 4.5 to 8.0
A high urine pH (alkaline urine) can be found in people who eat large quantities of citrus fruit and vegetables. Other causes include:
Kidney failure
Urinary tract infection
Kidney stones made up from calcium carbonate, calcium phosphate, and struvite (magnesium ammonium phosphate)
Respiratory alkalosis
Metabolic alkalosis
A low urine pH (acid urine) can be found in people who eat large quantities of meat. Other causes include:
Metabolic acidosis
Respiratory acidosis
Kidney stones made up from xanthine, cystine, and uric acid
Diabetes
Diarrhea
Starvation
Fanconi syndrome
Milkman syndrome
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
013037: pH, Urine | LabCorp [accessed on Jan 04, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Protein in Urine Test
Protein in Urine Test
Also called: Urine Protein
A protein in urine test measures how much protein is in your urine. A large amount of protein can indicate a problem with your kidneys.
Protein in Urine Test
Also called: Urine Protein
A protein in urine test measures how much protein is in your urine. A large amount of protein can indicate a problem with your kidneys.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Normal results vary based on the laboratory and the method used.
Related conditions
A protein in urine test measures how much protein is in your urine. Proteins are substances that are essential for your body to function properly. Protein is normally found in the blood. If there is a problem with your kidneys, protein can leak into your urine. While a small amount is normal, a large amount of protein in urine may indicate kidney disease.
A protein in urine test is often part of a urinalysis, a test that measures different cells, chemicals, and substances in your urine. Urinalysis is often included as part of a routine exam. This test may also be used to look for or to monitor kidney disease.
Your health care provider may have ordered a protein test as part of your regular checkup, or if you have symptoms of kidney disease. These symptoms include:
Difficulty urinating
Frequent urination, especially at night
Nausea and vomiting
Loss of appetite
Swelling in the hands and feet
Fatigue
Itching
A protein in urine test can be done in the home as well as in a lab. If in a lab, you will receive instructions to provide a "clean catch" sample. The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
If at home, you will use a test kit. The kit will include a package of strips for testing and instructions on how to provide a clean catch sample. Talk to your health care provider if you have any questions.
Your health care provider may also request you collect all your urine during a 24-hour period. This "24-hour urine sample test" is used because the amounts of substances in urine, including protein, can vary throughout the day. Collecting several samples in a day may provide a more accurate picture of your urine content.
You don't need any special preparations to test for protein in urine. If your health care provider has ordered a 24-hour urine sample, you will get specific instructions on how to provide and store your samples.
There is no known risk to having a urinalysis or a urine in protein test.
If a large amount of protein is found in your urine sample, it doesn't necessarily mean that you have a medical problem needing treatment. Strenuous exercise, diet, stress, pregnancy, and other factors can cause a temporary rise in urine protein levels. Your health care provider may recommend additional urinalysis tests if a high level of protein is found. This testing may include a 24-hour urine sample test.
If your urine protein levels are consistently high, it may indicate kidney damage or other medical condition. These include:
Urinary tract infection
Lupus
High blood pressure
Preeclampsia, a serious complication of pregnancy, marked by high blood pressure. If it is not treated, preeclampsia can be life-threatening to the mother and baby.
Diabetes
Certain types of cancer
To learn what your results mean, talk to your health care provider.
If you will be doing your urine test at home, ask your health care provider for recommendations on which test kit would be best for you. At-home urine tests are easy to do and provide accurate results as long as you carefully follow all instructions.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (2)
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
When kidneys are diseased or damaged, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
Urine Total Protein Test for Diseased Glomerulus : The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli, which remove waste products from the blood while preventing the loss of other components, including proteins, which are recycled in the body. When kidneys are diseased or damaged, however, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
Image by TheVisualMD
Urine Color Chart
OpenStax College
When kidneys are diseased or damaged, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
TheVisualMD
Urobilinogen Test
Urobilinogen Test
Also called: Urinary Urobilinogen
A urobilinogen in urine test looks for liver disease or damage. It may be included in a routine exam or if a liver problem is suspected.
Urobilinogen Test
Also called: Urinary Urobilinogen
A urobilinogen in urine test looks for liver disease or damage. It may be included in a routine exam or if a liver problem is suspected.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
A urobilinogen in urine test measures the amount of urobilinogen in a urine sample. Urobilinogen is formed from the reduction of bilirubin. Bilirubin is a yellowish substance found in your liver that helps break down red blood cells. Normal urine contains some urobilinogen. If there is little or no urobilinogen in urine, it can mean your liver isn't working correctly. Too much urobilinogen in urine can indicate a liver disease such as hepatitis or cirrhosis.
A urobilinogen test may part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. A urinalysis is often part of a routine exam.
Your health care provider may have ordered this test as part of your regular checkup, to monitor an existing liver condition, or if you have symptoms of a liver disease. These include:
Jaundice, a condition that causes your skin and eyes to turn yellow
Nausea and/or vomiting
Dark colored urine
Pain and swelling in the abdomen
Itchy skin
Your health care provider will need to collect a sample of your urine. He or she will provide you with special instructions to ensure the sample is sterile. These instructions are often called as the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having this test.
If your test results show too little or no urobilinogen in your urine, it may indicate:
A blockage in the structures that carry bile from your liver
A blockage in the blood flow of the liver
A problem with liver function
If your test results show a higher-than-normal level of urobilinogen, it may indicate:
Hepatitis
Cirrhosis
Liver damage due to drugs
Hemolytic anemia, a condition in which red blood cells are destroyed before they can be replaced. This leaves the body without enough healthy red blood cells
If your results are abnormal, it does not necessarily indicate you have a medical condition requiring treatment. Be sure to tell your health care provider about any medicines and supplements you are taking, as these can affect your results. If you are a woman, you should tell your health care provider if you are menstruating.
This test is only one measure of liver function. If your health care provider thinks you might have a liver disease, additional urine and blood tests may be ordered.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (4)
Bilirubin Metabolism
Video by Armando Hasudungan/YouTube
Urinalysis
Kidneys and Related Conditions : The value of routine urinalysis is that abnormal levels of substances such as protein or glucose, for example, will often appear in the urine before patients are aware they may have a problem. It is also used to detect disorders of the urinary tract, most commonly infections. Abnormal urine screens are typically followed up by more specific diagnostic tests.
Image by TheVisualMD
Alkaline Phosphatase, Liver
The liver is the body's central chemical plant, filtering blood and removing toxins, storing sugars, lipids, and vitamins, and producing important blood proteins. Liver function is typically evaluated by a panel of tests, including one for alkaline phosphatase (ALP), an enzyme made in liver cells, that help doctors distinguish among the many different possible causes of liver damage. Many types of liver damage, including hepatitis, cirrhosis, liver cancer or drug toxicity, can elevate ALP levels.
Image by TheVisualMD
Liver and Gallbladder with Associated Vessel
The liver is the body's central chemical plant, filtering blood and removing toxins, storing sugars, lipids, and vitamins, and producing important blood proteins such as albumin as well as those involved in blood clotting. The liver also produces most of body's cholesterol (the rest comes from food) as well as a quart of bile each day, a greenish-brown, alkaline fluid that aids digestion. The gallbladder stores bile for release into the small intestine; bile contains cholesterol, bile salts, and bilirubin, a yellowish pigment produced by the breakdown of red blood cells.
Image by TheVisualMD
8:44
Bilirubin Metabolism
Armando Hasudungan/YouTube
Urinalysis
TheVisualMD
Alkaline Phosphatase, Liver
TheVisualMD
Liver and Gallbladder with Associated Vessel
TheVisualMD
Nitrites in Urine Test
Nitrites in Urine Test
Also called: Urine Nitrite
A nitrites in urine test is part of a urinalysis, a test that measures different substances in urine. If nitrites are present, it may indicate an infection.
Nitrites in Urine Test
Also called: Urine Nitrite
A nitrites in urine test is part of a urinalysis, a test that measures different substances in urine. If nitrites are present, it may indicate an infection.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Even if no nitrites are found, you still may have an infection, because bacteria don't always change nitrates into nitrites.
Related conditions
A urinalysis, also called a urine test, can detect the presence of nitrites in the urine. Normal urine contains chemicals called nitrates. If bacteria enter the urinary tract, nitrates can turn into different, similarly named chemicals called nitrites. Nitrites in urine may be a sign of a urinary tract infection (UTI).
UTIs are one of the most common types of infections, especially in women. Fortunately, most UTIs are not serious and are usually treated with antibiotics. It's important to see your health care provider if you have symptoms of a UTI so you can start treatment right away.
Other names: urine test, urine analysis, microscopic urine analysis, microscopic examination of urine, UA
A urinalysis, which includes a test for nitrites in urine, may be part of a regular exam. It may also be used to check for a UTI.
Your health care provider may have ordered a urinalysis as part of a routine checkup or if you have symptoms of a UTI. Symptoms of a UTI may include:
Frequent urge to urinate, but little urine comes out
Painful urination
Dark, cloudy, or reddish colored urine
Bad smelling urine
Weakness and fatigue, particularly in older women and men
Fever
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider
You don't need any special preparations to test for nitrites in urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a nitrites in urine test.
If there are nitrites in your urine, it may mean that you have a UTI. However, even if no nitrites are found, you still may have an infection, because bacteria don't always change nitrates into nitrites. If you have symptoms of a UTI, your health care provider will also look at other results of your urinalysis, especially the white blood cell count. A high white blood cell count in urine is another possible sign of an infection. To learn what your results mean, talk to your health care provider.
If a urinalysis is part of your regular checkup, your urine will be tested for a variety of substances along with nitrites. These include red and white blood cells, proteins, acid and sugar levels, cell fragments, and crystals in your urine.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (2)
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
Lower urinary tract infection (cystitis) - an Osmosis preview
Video by Osmosis/YouTube
Urine Color Chart
OpenStax College
0:45
Lower urinary tract infection (cystitis) - an Osmosis preview
Osmosis/YouTube
Red Blood Cells in Urine Test
Red Blood Cells in Urine Test
Also called: RBC urine
Red blood cells (RBCs), also known as erythrocytes, may also be found in a urinalysis, or a urine test. High levels of RBCs in your urine indicates that you have hematuria.
Red Blood Cells in Urine Test
Also called: RBC urine
Red blood cells (RBCs), also known as erythrocytes, may also be found in a urinalysis, or a urine test. High levels of RBCs in your urine indicates that you have hematuria.
{"label":"Red Blood Cells in Urine Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"{cells}\/uL","code":"{cells}\/uL","name":"cells per microliter"}],"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":5},"text":"This indicates that only small traces of blood was found in your urine. It is considered normal and does not require further investigation.","conditions":[]},{"flag":"abnormal","label":{"short":"One cross (+)","long":"One cross (+)","orientation":"horizontal"},"values":{"min":5,"max":25},"text":"This indicates that small but significant traces of blood was found in your urine. Repeat test may be necessary and should be looked at in clinical setting.","conditions":["Persistent microscopic haematuria","Glomerular disorders","Glomerulonephritis","Systemic lupus erythematosus","Renal disorders","Polycystic kidney disease","Benign prostatic hyperplasia","Cancer","Cystitis","Pyelonephritis","Nephrolithiasis","Prostatitis","Intake or certain drugs","Trauma"]},{"flag":"abnormal","label":{"short":"Two crosses (++)","long":"Two crosses (++)","orientation":"horizontal"},"values":{"min":25,"max":100},"text":"This indicates that significant traces of blood was found in your urine. Further testing is necessary.","conditions":["Glomerular disorders","Glomerulonephritis","Systemic lupus erythematosus","Renal disorders","Polycystic kidney disease","Benign prostatic hyperplasia","Cancer","Cystitis","Pyelonephritis","Nephrolithiasis","Prostatitis","Intake or certain drugs","Trauma"]}],"value":2.5}[{"normal":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your
health.
{cells}/uL
5
25
Your result is Normal.
This indicates that only small traces of blood was found in your urine. It is considered normal and does not require further investigation.
Related conditions
Red blood cells (RBCs), also known as erythrocytes, are cells that can be found circulating in the blood. They are produced in the bone marrow (the spongy tissue inside some of your bones), and their function is to carry a protein called hemoglobin through the body, which in turn delivers oxygen to the tissues and organs.
This test is part of the microscopic characteristics evaluated in a urinalysis, or urine test. This means that RBCs are invisible to the naked eye, and can only be seen through a microscope.
This test is not usually ordered alone but rather as part of a urinalysis. It can be helpful in the following cases:
Overall check up
To monitor pregnant women
If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
To monitor a medical condition, such as diabetes or kidney disease
You will need to give a clean catch urine sample.
This requires following these simple steps;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
Is not unusual to find RBCs in a urine sample; however, 3 or more red blood cells per high-powered field are regarded as a sign of hematuria (blood loss through urine).; further information should be gathered to make a diagnose.
Presence of RBC’s in urine may be due to:
Glomerular disorders
Glomerulonephritis
Systemic lupus erythematosus
Renal disorders
Polycystic kidney disease
Benign prostatic hyperplasia
Cancer
Cystitis
Pyelonephritis
Nephrolithiasis
Prostatitis
Intake or certain drugs
Trauma
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, menstruation traces, and the time elapsed between the urine collection and its evaluation in the laboratory.
Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
Urinalysis [accessed on Jan 10, 2019]
Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
https://www.cambridgeshireandpeterboroughccg.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=7479 [accessed on Jan 10, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Hematuria
Hematuria Trauma : Gross hematuria due to kidney trauma.
Image by James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Hematuria by anatomic location
Source of Hematuria by anatomic location
Image by Copene
Microhematuria
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Phenazopyridine
Pyridiumurine : The characteristic color of urine after taking pyridium.
Image by James Heilman, MD
Hematuria
James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Bobjgalindo
Hematuria by anatomic location
Copene
Microhematuria
Bobjgalindo
Phenazopyridine
James Heilman, MD
White Blood Cells, Urine Test
White Blood Cells, Urine Test
Also called: Leukocytes in Urine
White blood cells (WBCs), also known as leukocytes, may also be found in a urinalysis, or a urine test. High levels of WBCs in your urine suggest that you have a urinary tract infection (UTI).
White Blood Cells, Urine Test
Also called: Leukocytes in Urine
White blood cells (WBCs), also known as leukocytes, may also be found in a urinalysis, or a urine test. High levels of WBCs in your urine suggest that you have a urinary tract infection (UTI).
{"label":"White Blood Cells, Urine Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"{cells}\/uL","code":"{cells}\/uL","name":"cells per microliter"}],"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":10},"text":"Normal reference ranges can slightly vary depending on the laboratory and the method used for testing.","conditions":[]},{"flag":"borderline","label":{"short":"Borderline","long":"Borderline","orientation":"horizontal"},"values":{"min":10,"max":100},"text":"This is usually not significant but still requires further clinical assessment. Discuss your result with your doctor. ","conditions":["Urinary tract infection","Vaginal infection"]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":100,"max":200},"text":"A high number of WBCs may indicate a urinary tract infection or inflammation, especially if bacteria is also present.","conditions":["Urinary tract infection","Urinary tract inflammation","Pyelonephritis","Glomerulonephritis","Interstitial nephritis","Renal inflammatory processes"]}],"value":5}[{"normal":0},{"borderline":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
{cells}/uL
10
100
Your result is Normal.
Normal reference ranges can slightly vary depending on the laboratory and the method used for testing.
Related conditions
White blood cells (WBCs), also known as leukocytes, are part of the immune system. These cells protect your body against viruses, bacteria, parasites, fungus, and any other strange organism or substance that may want to enter into your system.
This test is part of the microscopic characteristics evaluated in a urinalysis, or urine test. This means that WBCs are invisible to the naked eye, and can only be seen through a microscope.
This test is not ordered alone but rather as part of a urinalysis. It can be helpful in the following cases:
Overall check up
To monitor pregnant women
If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
You will need to give a clean catch urine sample.
This requires following these simple steps;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
The normal range for WBCs in urine is:
<10 WBC/µl: not significant
10-100 WBC/µl: usually not significant but still requires further clinical assessment
>100 WBC/µl: suggestive of infection
It is also considered normal to have less than 5 WBCs/hpf. A high number of WBCs may indicate a urinary tract infection or inflammation, especially if bacteria is also present.
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
Urinalysis [accessed on Jan 10, 2019]
Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
https://www.cambridgeshireandpeterboroughccg.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=7479 [accessed on Jan 10, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (1)
Pyuria
Pyuria : White blood cells seen under a microscope from a urine sample.
Image by Bobjgalindo
Pyuria
Bobjgalindo
Epithelial Cells in Urine Test
Epithelial Cells in Urine Test
The test measures the amount of epithelial cells in urine. A large amount may indicate an infection, kidney disease, or other serious medical condition. This test is part of a urinalysis, a test that measures different substances in your urine.
Epithelial Cells in Urine Test
The test measures the amount of epithelial cells in urine. A large amount may indicate an infection, kidney disease, or other serious medical condition. This test is part of a urinalysis, a test that measures different substances in your urine.
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Use the slider below to see how your results affect your
health.
Your result is Few.
"Few" cells are generally considered in the normal range.
Related conditions
Epithelial cells are a type of cell that lines the surfaces of your body. They are found on your skin, blood vessels, urinary tract, and organs. An epithelial cells in urine test looks at urine under a microscope to see if the number of your epithelial cells is in the normal range. It's normal to have a small amount of epithelial cells in your urine. A large amount may indicate an infection, kidney disease, or other serious medical condition.
An epithelial cells in urine test is a part of a urinalysis, a test that measures different substances in your urine. A urinalysis may include a visual examination of your urine sample, tests for certain chemicals, and an examination of urine cells under a microscope. An epithelial cells in urine test is part of a microscopic exam of urine.
Your health care provider may have ordered an epithelial cells in urine test as part of your regular checkup or if your visual or chemical urine tests showed abnormal results. You may also need this test if you have symptoms of a urinary or kidney disorder. These symptoms may include:
Frequent and/or painful urination
Abdominal pain
Back pain
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container. The container will have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations for the test. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having the test.
Results are often reported as an approximate amount, such as "few," moderate," or "many" cells. "Few" cells are generally considered in the normal range. "Moderate" or "many" cells may indicate a medical condition such as:
Urinary tract infection
Yeast infection
Kidney disease
Liver disease
Certain types of cancer
If your results are not in the normal range, it doesn't necessarily mean that you have a medical condition that requires treatment. You may need more tests before you can get a diagnosis. To learn what your results mean, talk to your health care provider.
There are three types of epithelial cells that line the urinary tract. They are called transitional cells, renal tubular cells, and squamous cells. If there are squamous epithelial cells in your urine, it may mean your sample was contaminated. This means that the sample contains cells from the urethra (in men) or the vaginal opening (in women). It can happen if you do not clean well enough when using the clean catch method.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Uric acid crystals (urine)
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Struvite crystals (urine)
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Urine Test
Image by frolicsomepl/Pixabay
Urine
Sample of human urine
Image by Markhamilton
Cancer screening
Screening for Cancer: Urine Tests : Urine samples may contain tumor markers, which can suggest cancer. Urinalysis is commonly a part of routine health screening. It is simply an analysis of the urine that can be performed in many healthcare settings including doctors' offices, urgent care facilities, laboratories, and hospitals. Urinalysis can disclose evidence of diseases, even some that have not caused significant signs or symptoms.
Image by TheVisualMD
Uric acid crystals (urine)
Doruk Salancı
Struvite crystals (urine)
Doruk Salancı
Urine Test
frolicsomepl/Pixabay
Urine
Markhamilton
Cancer screening
TheVisualMD
Urinary Casts Test
Urinary Casts Test
Also called: Urine Casts
Urinary casts are tiny structures that can be seen in a urine test (urinalysis) when certain kidney diseases or conditions are present.
Urinary Casts Test
Also called: Urine Casts
Urinary casts are tiny structures that can be seen in a urine test (urinalysis) when certain kidney diseases or conditions are present.
Use the slider below to see how your results affect your
health.
Your result is Negative.
Related conditions
Urinary casts are tiny cylindrical, tube-shaped structures that are produced by the kidneys and may be found in a urinalysis test when certain diseases or conditions are present.
This test usually forms part of a urine test (urinalysis), which can be ordered as part of a normal routine check-up, or when kidney diseases are suspected.
You will be asked to provide a urine sample by urinating into a sterile urine container.
To adequately do this, you need to clean your genitals, and then discard the first stream of urine into the toilet (this is done to “clean” your urethra), proceeding then to collect about two ounces of midstream urine in the container.
No fasting or other preparations are necessary for this test. Follow the instructions provided by your healthcare professional.
There are no known risks associated with this test.
Hyaline casts: the presence of a few of these casts is usually normal and can occur in physiologic states (e.g., after exercise).
Fatty casts: these casts can be found in people who have lipids (fat) in the urine and are usually related to a kidney disease complication, such as nephrotic syndrome, glomerulonephritis, or other forms of chronic renal diseases.
Granular casts: these casts might be found after exercise, but also when certain kidney diseases are present.
Red blood cell casts: these casts are related to a very small amount of bleeding from the kidney. Red blood cell casts are seen in many kidney diseases.
Epithelial cell casts: the apparition of these casts implies damage to cells in the kidneys. These casts are seen in conditions such as heavy metal poisoning, and kidney transplant rejection, among others.
Waxy casts: these casts can be found in people with long-term (chronic) kidney disease and chronic kidney failure.
White blood cell (WBC) casts: these casts can be found when acute kidney infections are present.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
V/Q Scan
V/Q Scan
Also called: Lung VQ Scan, Lung Ventilation/Perfusion Scan, Nuclear Medicine V/Q Scan, Pulmonary Ventilation/Perfusion Scan, Ventilation/Perfusion Scan
A V/Q scan is an imaging test that uses a ventilation (V) scan to measure air flow in your lungs and a perfusion (Q) scan to see where blood flows in your lungs. It is most often used to check for a pulmonary embolism (PE), a life-threatening blockage of an artery in the lungs.
V/Q Scan
Also called: Lung VQ Scan, Lung Ventilation/Perfusion Scan, Nuclear Medicine V/Q Scan, Pulmonary Ventilation/Perfusion Scan, Ventilation/Perfusion Scan
A V/Q scan is an imaging test that uses a ventilation (V) scan to measure air flow in your lungs and a perfusion (Q) scan to see where blood flows in your lungs. It is most often used to check for a pulmonary embolism (PE), a life-threatening blockage of an artery in the lungs.
A V/Q scan consists of two imaging tests that look for certain lung problems. The tests are:
A ventilation scan, which measures how air moves in and out of your lungs
A perfusion scan, which measures circulation (how blood flows in the lungs)
The two scans may be done separately or together.
A V/Q scan uses a small amount of a radioactive substance called a tracer that helps look for disease in the body. The scans help diagnose different lung conditions, including a pulmonary embolism (PE). A PE is a life-threatening blockage in an artery in the lungs. It usually happens when a blood clot in another part of the body breaks loose and travels to the lungs.
A V/Q scan is most often used to check for a pulmonary embolism (PE). It may also be used to:
Find problems with blood flow in the lungs
Check lung function before lung surgery
Test lung function in people with certain lung diseases, such as COPD (chronic obstructive pulmonary disease), a disease that causes coughing, wheezing, and shortness of breath.
You may need a V/Q scan if you have symptoms of a pulmonary embolism (PE). These include:
Trouble breathing
Chest pain
Coughing or coughing up blood
Rapid heartbeat
Many people with a PE don't have symptoms. But your provider may order a V/Q scan based on a physical exam and/or if you have certain risk factors. These include:
Family history of blood clots or PE
Long periods of inactivity that may be due to prolonged sitting (such as from long car trips or flights), bed rest or other reasons
Recent surgery
Obesity
Older age
Smoking
You may also be at higher risk if you have:
A clotting disorder
Cancer
Heart disease
Another lung disease, such as COPD
V/Q scans are usually performed in a radiology clinic or a hospital. You may be getting a ventilation scan or a perfusion scan, or you may get both scans. If you are getting both, one scan will be done right after the other.
For both types of scans:
You will lie very still on a special table while the scanner takes pictures of your lungs.
Before the scan, you will be given a substance called a radioactive tracer. The tracer sends out a form of energy called gamma rays. The rays are picked up by the scanner to create images of your lungs.
During a ventilation scan:
You will wear a face mask and breathe in a gas that contains the radioactive tracer
A health care provider will use the scanner to take pictures of your lungs while you are holding your breath.
Your provider will continue to take pictures while you breathe in the tracer gas for a few more minutes.
After the tracer gas has collected in your lungs, your provider will remove your face mask. As you breathe normally, the tracer will leave your lungs.
During a perfusion scan:
A health care provider will inject the radioactive tracer into your vein through an intravenous (IV) line.
The tracer will collect in the blood vessels of your lungs.
Your provider will use the scanner to take pictures of your lungs.
You will be moved into several positions during the test so the scanner can capture images of the lungs from different angles.
A chest x-ray is usually done before a V/Q scan.
There is very little exposure to radiation in a V/Q scan. Only a small amount of radioactive substance is used, and all of the radiation leaves the body within a few days.
While radiation exposure in a V/Q scan is safe for most adults, it can be harmful to an unborn baby. So be sure to tell your provider if you are pregnant or think you may be pregnant Also, tell your provider if you are breastfeeding, because the tracer may contaminate your breast milk.
You may have a little discomfort when the tracer is injected during a perfusion scan.
Allergic reactions to the tracer are rare and usually mild.
If your ventilation and/or perfusion scan results were not normal, it may mean you have a pulmonary embolism (PE) and will need medical treatment right away.
The scans may also show that you have a different condition affecting your lungs. These include:
COPD
Pneumonia
Heart failure
If you have questions about your results, talk to your health care provider.
If you are diagnosed with a pulmonary embolism (PE), your treatment may include medicines such as blood thinners, which help prevent clots from forming, or clot busters, which help dissolve clots quickly.
If the medicines don't work, or you have a very large clot, you may need a surgical procedure to prevent and/or remove the clots.
https://medlineplus.gov/lab-tests/vq-scan/ [accessed on Sep 27, 2021]
https://medlineplus.gov/ency/article/003828.htm [accessed on Sep 27, 2021]
https://www.nhlbi.nih.gov/health-topics/lung-vq-scan [accessed on Sep 27, 2021]
https://radiopaedia.org/articles/vq-scan-2?lang=us [accessed on Sep 27, 2021]
Additional Materials (10)
Ischemia caused by Pulmonary Embolism
The most dangerous complication of deep vein thrombosis is pulmonary embolism, which occurs when a blood clot travels to the lungs and lodges in a pulmonary artery. The lungs are particularly vulnerable to emboli because blood must pass through the lung vessels every time it circulates. During an episode of pulmonary embolism, the lungs may be showered with multiple clots. The condition can be completely asymptomatic, or may cause chest pain, shortness of breath, tachycardia, or sudden death. In some cases, pulmonary emboli may be associated with localized destruction of lung tissue known as pulmonary infarction (pictured here).
Image by TheVisualMD
Flow and perfusion | Circulatory system physiology | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
livingwithph.ca - VQ Lung Scan
Video by PHA Canada/YouTube
Lung Perfusion
Video by Julie Bolin/YouTube
What Is a Lung Ventilation/Perfusion Scan?
Ventilation-perfusion scintigraphy in a woman taking oral contraceptives and valdecoxib with a pulmonary embolism. (A) After inhalation of 20.1 mCi of Xenon-133 gas, scintigraphic images were obtained in the posterior projection, showing uniform ventilation to lungs.. (B) After intravenous injection of 4.1 mCi of Technetium-99m-labeled macroaggregated albumin, scintigraphic images were obtained, shown here in the posterior projection. This and other views showed decreased activity in the following regions: apical segment of right upper lobe, anterior segment of right upper lobe, superior segment of right lower lobe, posterior basal segment of right lower lobe, anteromedial basal segment of left lower lobe, and lateral basal segment of left lower lobe.
Image by Westgate EJ, FitzGerald GA
Pulmonary Embolism
Although a thrombus may develop over an extended period of time, it can become potentially deadly in seconds when part of it breaks off as an embolus. Pulmonary emboli that originate in the deep leg veins travel up the vena cava, through the right chambers of the heart, and into the lungs. An estimated 600,000 cases of pulmonary embolism occur each year in the US, resulting in up to 200,000 deaths.
Image by TheVisualMD
What To Expect Before, During and After a Lung Ventilation/Perfusion Scan?
Ventilation-perfusion lung scan reveals bilateral ventilation and complete absence of perfusion in the left lung.
Image by Lal C, Barker J, Strange C
What Is Pulmonary Embolism?
The most dangerous complication of deep vein thrombosis (DVT) is pulmonary embolism, which occurs when an embolism travels through the heart and into the lungs. There it lodges in an artery, typically where the artery forks, and blocks blood flow. The lungs are particularly vulnerable to embolisms because all the blood in the body passes through the lungs every time it circulates.
Image by TheVisualMD
Ventilation/perfusion scan
subFusion processing applied to a SPECT lung ventilation-perfusion scan.
Image by KieranMaher at English Wikibooks
Thorax with Muscle Involved in Respiration
3D visualization of an anterior view of the muscles involved in respiration. The primary job of the thorax is to promote movements necessary for breathing. Three muscles of the thorax assist in this function; the external intercostals, internal intercostals and diaphragm. The intercostals do the job of lifting the ribs up and pulling them outward, which in turn enlarges the lungs. As the lungs expand, the pressure inside them is reduced, and they suck in air. During extreme inhalation, the neck muscles also contract. During inhalation, the diaphragm contracts and pushes downward; during exhalation, it relaxes and is pushed up into a dome shape by the lower digestive organs, compressing the lungs. As pressure rises in the chest cavity, exhale occurs, pressure is equalized and the cycle restarts.
Image by TheVisualMD
Ischemia caused by Pulmonary Embolism
TheVisualMD
10:31
Flow and perfusion | Circulatory system physiology | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
1:27
livingwithph.ca - VQ Lung Scan
PHA Canada/YouTube
6:41
Lung Perfusion
Julie Bolin/YouTube
What Is a Lung Ventilation/Perfusion Scan?
Westgate EJ, FitzGerald GA
Pulmonary Embolism
TheVisualMD
What To Expect Before, During and After a Lung Ventilation/Perfusion Scan?
Lal C, Barker J, Strange C
What Is Pulmonary Embolism?
TheVisualMD
Ventilation/perfusion scan
KieranMaher at English Wikibooks
Thorax with Muscle Involved in Respiration
TheVisualMD
Treatment
Amoxicillin
Image by Brett Hondow
Amoxicillin
Amoxicillin - Antibiotics
Image by Brett Hondow
Legionnaires' Disease and Pontiac Fever - Treatment and Complications
Legionnaires’ Disease Treatment and Complications
Legionnaires’ disease requires treatment with antibiotics and most cases of this illness can be treated successfully. Healthy people usually get better after being sick with Legionnaires’ disease, but they often need care in the hospital.
Possible complications of Legionnaires’ disease include
Lung failure
Death
About 1 out of every 10 people who gets sick with Legionnaires’ disease will die due to complications from their illness. For those who get Legionnaires’ disease during a stay in a healthcare facility, about 1 out of every 4 will die.
Pontiac Fever Treatment and Complications
Pontiac fever goes away without requiring treatment.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (3)
What Antibiotics Treat and Won’t Treat Animation
Be Antibiotics Aware by using antibiotics only when needed.
Image by Centers for Disease Control and Prevention (CDC)
Novamoxin Antibiotic
Novamoxin Prescription Drug - Amoxicillin Trihydrate (H-6) 500 mg
Image by Bmramon at English Wikipedia
Bottle of Doxycycline
Capsules of the antibiotic doxycycline spill from a medication bottle. Oral antibiotics, such as doxycycline or amoxicillin, are often prescribed after exposure to tickborne Lyme disease.
Image by NIAID
What Antibiotics Treat and Won’t Treat Animation
Centers for Disease Control and Prevention (CDC)
Novamoxin Antibiotic
Bmramon at English Wikipedia
Bottle of Doxycycline
NIAID
Prevention
Inside cooling tower
Image by Jan Beránek
Inside cooling tower
Interior of natural draft cooling tower, showing internal chimney in operation, Tušimice power plant
Image by Jan Beránek
Prevention of Legionnaires Disease
Water Management Programs
There are no vaccines that can prevent Legionnaires’ disease.
Instead, the key to preventing Legionnaires’ disease is to reduce the risk of Legionellagrowth and spread. Building owners and managers can do this by maintaining building water systems and implementing controls for Legionella. Examples of building water systems that might grow and spread Legionella include:
Showerheads and sink faucets
Cooling towers (structures that contain water and a fan as part of centralized air cooling systems for buildings or industrial processes)
Hot tubs
Decorative fountains and water features
Hot water tanks and heaters
Large, complex plumbing systems
CDC developed a toolkit to help building owners and managers develop and implement a water management program. Creating and implementing a water management program can reduce their building’s risk for growing and spreading Legionella.
Legionella and Hot Tubs
Home and car air-conditioning units do not use water to cool the air, so they are not a risk for Legionellagrowth.
Legionella grows best in warm water, like the water temperatures used in hot tubs. Warm temperatures also make it hard to keep disinfectants, such as chlorine, at the levels needed to kill germs like Legionella. The levels of disinfectants and other chemicals in hot tubs should be checked regularly and hot tubs should be cleaned as recommended by the manufacturer. Learn how you can test the water before you use a hot tub and questions you should ask your hot tub operator to determine whether or not a hot tub has been properly maintained:
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (3)
Soak Up the Rain with Green Infrastructure - EPA
Poster, "Soak Up the Rain with Green Infrastructure."
Image by EPA/Wikimedia
Prevention of Legionnaires' Disease
Video by 衞生署衞生防護中心, CHP, Department of Health, HKSARG/YouTube
Turning the Tide: The Role of Water Management to Prevent Legionnaires’ Disease
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Soak Up the Rain with Green Infrastructure - EPA
EPA/Wikimedia
2:02
Prevention of Legionnaires' Disease
衞生署衞生防護中心, CHP, Department of Health, HKSARG/YouTube
11:07
Turning the Tide: The Role of Water Management to Prevent Legionnaires’ Disease
Centers for Disease Control and Prevention (CDC)/YouTube
Healthy Swimming, Healthy Water
Pregnant hot tub
Image by Schwangerschaft/Wikimedia
Pregnant hot tub
Pregnant woman in a hot tub
Image by Schwangerschaft/Wikimedia
Legionella Infections and Swimming
Swimmers are at risk for respiratory infections if they breathe in small droplets of water (mist) from a pool or hot tub that contains harmful germs. A respiratory disease caused by the germ Legionella is one of the most common waterborne diseases in the United States.
Legionella and Hot Tubs/Spas
Legionella is a germ that can cause a severe type of pneumonia (lung infection) called Legionnaires’ disease. Legionella can also cause Pontiac fever, a milder illness without pneumonia. Make sure disinfectants in hot tubs/spas (like chlorine) are kept at the level and pH needed to reduce the risk of spreading germs like Legionella. If you have symptoms of Legionnaires’ disease or Pontiac fever, such as cough, shortness of breath, fever, or muscle aches, see your healthcare provider right away. Be sure to tell your healthcare provider if you used a hot tub/spa in the last two weeks.
Hot tubs/spas can spread Legionella
People can get Legionnaires’ disease or Pontiac fever when they breathe in small droplets of water (mist) that contain Legionella. Legionella is found naturally in freshwater environments, like lakes and streams. It becomes a health concern when it grows and spreads in human-made water systems. For example, Legionella can grow and multiply in hot tubs/spas that are not disinfected and cleaned properly.
Legionella can also be found in other human-made water systems such as cooling towers, plumbing systems, and decorative fountains.
People at risk
Certain groups of people are more likely to get Legionnaires’ disease:
People 50 years of age or older
Current or former smokers
People with chronic lung disease
People who have health problems or take medicines that lower their body’s ability to fight germs and sickness—such as people whose immune systems are weakened because of cancer, an organ transplant, or HIV
Protect yourself and others
Below are steps you can take to test hot tub/ spa water and find out if it is being properly maintained.
Buy test strips at your local retailer or pool supply store. Be sure to check the expiration date.
Use the test strips to check these levels:
Free chlorine level should be 3–10 parts per million
Bromine level should be 4–8 parts per million
pH should be 7.2–7.8
Tell the hot tub/spa operator or owner if you find improper chlorine or bromine levels or pH.
Questions to ask your hot tub/spa operator
What was the most recent health inspection score for the hot tub/spa?
Are the disinfectant levels and pH checked at least twice per day?
Are the disinfectant levels and pH checked more often when the hot tub is being used by a lot of people relative to its size?
Are the following maintenance activities performed?
Daily removal of the slime or biofilm layer by scrubbing and cleaning
Replacement of the hot tub/spa water filter according to the manufacturer’s recommendations
Replacement of hot tub/spa water as often as required by the health department or recommended by the manufacturer
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (3)
Legionella, Legionnaires' Disease & Hot Tubs
Video by Paul Cochrane/YouTube
Can Hot Tubs Make You Sick?
Video by SciShow/YouTube
Facts about Legionella and Hot Tubs/Spas
Legionella is naturally found in water, especially warm water. Hot tubs
(or spas) that are not cleaned and disinfected enough can become
contaminated with Legionella. A person can get infected with
Legionella when they breathe in steam or mist from a contaminated
hot tub.
Document by Centers for Disease Control and Prevention (CDC)
Send this HealthJournal to your friends or across your social medias.
Legionnaires' Disease
Legionella pneumophila. You get it by breathing in mist from water that contains the bacteria. Learn more about the symptoms, treatment, and prevention of Legionnaires' disease.