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The follow-up urine culture for urinary tract infection (UTI) is widely recommended, but it is done relatively infrequently in everyday practice. We thought an investigation of its effectiveness was warranted. The study population consisted of 141 women with a culture-proven symptomatic lower UTI. Of these, 56.7% (80) had a follow-up culture and 43.3% (61) did not. The two groups were found to be comparable in important parameters of risk for urinary tract infection and its complications. The relative risk of a subsequent symptomatic UTI was 0.5 for women who did not obtain a follow-up urine culture (95% confidence interval = 0.2 to 1.5). The follow-up urine culture in asymptomatic, healthy women may be unjustified.

We describe a case of Hemophilus parainfluenzae endocarditis in a previously healthy 26-year-old man, and review 21 cases from the literature. Although H parainfluenzae is considered to be part of the normal flora of the upper respiratory tract in man, it can cause serious disease. H parainfluenzae endocarditis is often difficult to diagnose. The patients generally had a history of recent infection of the upper respiratory tract, but a majority denied previous heart disease. Upon entry to the hospital, after an average of seven weeks of febrile illness, nearly one third of patients were found not to have a heart murmur. Furthermore, the organism was often difficult to grow from blood cultures, a problem possibly related to the need for accessory growth factors. The mortality with modern therapy was 12%, and the major complication was cerebral embolus. Antibiotic therapy of choice is ampicillin, generally used together with an aminoglycoside, though ampicillin alone may be sufficient.