A Tale of Two Crystals

A 37-year-old man with a history of nephrolithiasis presents with a recent UTI. What do the two distinct crystal types found in his urine reveal?

Cystine and triple phosphate (struvite) crystals


A 37-year-old man presented early in life with nephrolithiasis and pyelonephritis. Two weeks before this encounter, he was treated for a urinary tract infection. Microscopic examination of a spun urine specimen is shown, demonstrating two crystal types. What are these crystals, demonstrated in panels A and B, respectively?

What is the most likely diagnosis?

Calcium oxalate and triple phosphate (struvite) crystals
Cholesterol and acyclovir crystals
Cystine and triple phosphate (struvite) crystals
Sulfonamide and cystine crystals
Uric acid and calcium oxalate crystals

Cystine and triple phosphate (struvite) crystals, Cystinuria, Nephrolithiasis, Struvite, Urinalysis

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