Does examination of urinary sediment identify individuals with Gulf War syndrome? A pilot study

Background: Many veterans who were involved in the Persian Gulf theater of operations have had a variety of unexplained physical complaints, collectively called the Gulf War syndrome or similar names. There has been much debate on the issue and numerous publications, both in the medical and the lay press. A method for examining urinary sediment that was developed in an effort to identify nonculturable bacteria has been used in Gulf War veterans and was the basis for intensive antimicrobial therapy in many of them. Methods: We evaluated eight Gulf War veterans with complaints compatible with Gulf War syndrome. Subjects were from various parts of the United States. A detailed history and physical examination were performed. Urine was obtained before and after prostatic massage (men) or before and after pelvic examinations (women) and was tested by a previously described microscopic method as well as by culture and conventional Gram stain. Age- and sex-matched healthy control subjects were tested similarly and concurrently. Results: Two female Gulf War veterans had findings of Candida albicans and Klebsiella pneumoniae by conventional culture. The same organism types were seen both by the special method and by conventional Gram stain. All other subjects and controls were completely indistinguishable. Conclusion: Examining the urinary sediment by this elaborate method does not differentiate persons with Gulf War syndrome from normal, healthy control subjects who were never in the Persian Gulf area.