People who suspect leukocytes in the urine provide a urine sample that their doctor can analyze in three ways: Visual exam, dipstick test, and microscopic exam. If blood or other substances are present in the urine, the physician may perform more tests to identify the cause of the problem. The problem may be any of the conditions listed above or a more serious noninfectious illness, such as a blood disorder, autoimmune disease, or cancer.
The doctor will order additional tests as needed. It is possible to have white blood cells in the urine without a bacterial infection. Sterile pyuria refers to the persistent presence of white blood cells in the urine when no bacteria are found to be present by laboratory examination.
Certain sexually transmitted diseases , viral or fungal infections, or even tuberculosis can cause sterile pyuria. Treatment for leukocytes in the urine depends on the cause and if there is an infection. For some conditions, such as a bacterial UTI, antibiotic therapy will clear up the infection relatively quickly.
For more severe infections or those that will not resolve easily, more in-depth medical treatment may be needed. In some cases, hospitalization may be necessary. Lifestyle changes can help reduce the symptoms of some conditions that cause leukocytes to enter the urine. Taking acetaminophen, ibuprofen, or prescription drugs may also help to ease pain in the urinary system. Leukocytes are white blood cells that help protect people from infection. They are not usually present in the urine, so when they are present, it can….
A urinary tract infection can affect the bladder, the kidneys and the tubes that link them. Usually caused by bacteria, urinary tract infections are….
Learn more about lymphocytes, a type of white blood cell. We look at their function, normal levels, and what happens if levels are too high or too low. Leukopenia is a condition where a person has a reduced number of white blood cells and an increased risk of infection. Learn more. Why are there leukocytes in my urine? Medically reviewed by Stacy Sampson, D. Acute tubular necrosis, interstitial nephritis, eclampsia, nephritic syndrome, allograft rejection, heavy metal ingestion, renal disease.
Information from reference Urinary casts. Crystals may be seen in the urinary sediment of healthy patients Figure 4. Uric acid crystals are yellow to orange-brown and may be diamond- or barrel-shaped. Triple phosphate crystals may be normal but often are associated with alkaline urine and UTI typically associated with Proteus species. Cystine crystals are colorless, have a hexagonal shape, and are present in acidic urine, which is diagnostic of cystinuria.
Urinary crystals. A Calcium oxalate crystals arrows; X ; B uric acid crystals X ; C triple phosphate crystals with amorphous phosphates X ; D cystine crystals X. Gram staining can help guide antibiotic therapy, but it is not indicated in routine outpatient practice.
Clean-catch specimens from female patients frequently are contaminated by vaginal flora. In these patients, five bacteria per HPF represents roughly , colony-forming units CFU per mL, the classic diagnostic criterion for asymptomatic bacteriuria and certainly compatible with a UTI. The presence of bacteria in a properly collected male urine specimen is suggestive of infection, and a culture should be obtained.
Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. He received his medical degree from Georgetown University School of Medicine. JOHN J. Address correspondence to Jeff A. Simerville, M. Reprints are not available from the authors. The authors indicate that they do not have any conflicts of interest. Sources of funding: none reported. Lifshitz E, Kramer L. Outpatient urine culture: does collection technique matter?. Arch Intern Med.
Rabinovitch A. Urinalysis and collection, transportation, and preservation of urine specimens: approved guideline. Wayne, Pa. Dipstick urinalysis screening of asymptomatic adults for urinary tract disorders. Dipstick proteinuria: can it guide hypertension management?. Am J Kidney Dis. Dipstick urinalysis and the accuracy of the clinical diagnosis of urinary tract infection. J Emerg Med. Predicting urine culture results by dipstick testing and phase contrast microscopy.
Poor predictive ability of urinalysis and microscopic examination to detect urinary tract infection. Am J Clin Pathol. Reagent strip diagnosis of UTI in a high-risk population.
Am J Emerg Med. Comparison of test characteristics of urine dipstick and urinalysis at various test cutoff points. Ann Emerg Med. Semeniuk H, Church D. Evaluation of the leukocyte esterase and nitrite urine dipstick screening tests for detection of bacteriuria in women with suspected uncomplicated urinary tract infections. J Clin Microbiol. Leman P. Validity of urinalysis and microscopy for detecting urinary tract infection in the emergency department. Eur J Emerg Med. Kavouras SA.
Assessing hydration status. Sheets C, Lyman JL. Emerg Med Clin North Am. The urinalysis: a critical appraisal. Med Clin North Am. Benejam R, Narayana AS. Am Fam Physician. The significance of adult hematuria: 1, hematuria evaluations including a risk-benefit and cost-effectiveness analysis. J Urol. Evaluation of asymptomatic microscopic hematuria in adults: the American Urological Association best practice policy—part I: definition, detection, prevalence, and etiology.
Evaluation of asymptomatic microscopic hematuria in adults: the American Urological Association best practice policy—part II: patient evaluation, cytology, voided markers, imaging, cystoscopy, nephrology evaluation, and follow-up. Ahmed Z, Lee J. Detection of glomerular bleeding by phase-contrast microscopy. Brendler, CB. Evaluation of the urologic patient: history, physical examination and urinalysis. Philadelphia: Saunders, — Sutton JM.
Evaluation of hematuria in adults. Asymptomatic micro-hematuria and urologic disease. A population-based study. Is microscopic haematuria a urological emergency?. BJU Int. Isolated asymptomatic microhematuria: a cross-sectional analysis of test-positive and test-negative patients. J Gen Intern Med. The significance of asymptomatic microhematuria in men 50 or more years old: findings of a home screening study using urinary dipsticks.
A prospective analysis of 1, patients with hematuria to evaluate current diagnostic practice. Exercise-related hematuria. Findings in a group of marathon runners. Nephrology: 2. Evaluation of asymptomatic hematuria and proteinuria in adult primary care. Proteinuria in adults: a diagnostic approach. Prevalence and causes of proteinuria in year old Finnish men. Scand J Urol Nephrol. Fixed and reproducible orthostatic proteinuria: results of a year follow-up study.
Ann Intern Med. Rytand DA, Spreiter S. Prognosis in postural orthostatic proteinuria: forty to fifty-year follow-up of six patients after diagnosis by Thomas Addis. N Engl J Med. Performance characteristics of urine dipsticks stored in open containers. Fogazzi GB, Garigali G. The clinical art and science of urine microscopy. Curr Opin Nephrol Hypertens. Graham JC, Galloway A. ACP best practice no. J Clin Pathol. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.
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Get Permissions. Read the Issue. Sign Up Now. Previous: Treatment of Cholesterol Abnormalities. Mar 15, Issue. Urinalysis: A Comprehensive Review. C Am Fam Physician. A complete urinalysis includes physical, chemical, and microscopic examinations.
B 5 Patients with microscopic hematuria i. C 19 , 20 Exercise-induced hematuria is a relatively common, self-limited, and benign condition.
Figure 1. If you have small kidney stones, increasing the amount of water you drink can help flush them out of your system. Passing stones is often painful. Sometimes, larger stones are broken up using sound waves.
Surgery may also be necessary to remove large kidney stones. If the blockage occurs due to a tumor, treatment options may also include surgery, chemotherapy , or radiation.
If diagnosed early and treated thoroughly, UTIs usually clear up in a short amount of time. Kidney stones are also treatable. Benign tumors or other growths in the urinary tract may also be treated, but they may require surgery and recovery time. Cancerous growths may require longer-term treatment, as well as monitoring to watch for the spread of cancer to other parts of the body. One of the easiest ways to help keep your urinary tract free of infections or kidney stones is to stay hydrated.
Drink several glasses of water per day, but talk with your doctor about what amount of water is best for you. Eating cranberries and drinking cranberry juice may help lower your risk of developing UTIs. That is because a substance in cranberries may help protect your bladder and make it more difficult for certain bacteria to stick to your urinary tract. Learn more: 7 Best remedies for bladder infection ».
Tell your doctor if you notice anything unusual about your urine, such as its color , smell , or any discomfort you experience while urinating. A urinary tract infection that starts in the urethra can spread to the bladder and kidneys, which makes the problem much more serious and can lead to complications. Learn more about leukopenia, including its symptoms, causes, and how you can treat it.
A urinalysis is a laboratory test to detect problems with your body that can show signs in your urine. Problems with your lungs, kidneys, urinary…. Do you have a bladder infection? Learn about seven remedies for bladder infections that can ease symptoms and get rid of the infection.
Some of these…. Learn about the symptoms and causes of kidney infection, plus how this potentially serious condition is treated.
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