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Recurrent Pyuria, Negative Culture
60-year-old female with recurrent abnormal urine routine tests (2–3 episodes) despite urine cultures not showing bacterial growth.
Current urine routine:
* Pus cells >120 WBC/HPF (normal 0–5)
* Leukocyte esterase 3+
* RBC 10–13/HPF
* Blood 2+
* Nitrite negative
* No crystals/casts
* No burning or other significant urinary symptoms
Previous urine test also showed 25–30 pus cells/WBC per HPF.
Current urine culture interim report shows no organism isolated so far, and similar culture-negative episodes have happened previously.
What could cause recurrent high pus cells/pyuria with negative urine cultures, and which specialist should we consult? Should this be investigated further before giving repeated antibiotics?
Answers (11)
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Pus cells this high with a negative culture usually mean something other than a typical bacterial infection, especially since you don't have burning or other symptoms.
Next Steps
A urologist or urogynaecologist can guide you through further tests like urine cytology or imaging before any more antibiotics.
Health Tips
Repeated antibiotics without a confirmed infection can do more harm than good, so it's worth getting this properly evaluated first.
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Consult for discussion and treatment
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Connect please
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Recurrent sterile pyuria needs evaluation by a urologist. Avoid repeated antibiotics until the underlying cause is identified.
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Consult urologist for further discussion
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Can be due urinary tb also,need further history and evaluation
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Dr. Ramkumar Suryavanshi
Urologist
14 yrs exp
Bilaspur
Consult
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Dr. Anantbir Singh Lubana
Urologist
13 yrs exp
Ludhiana
Connect to
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Dr. Jatin Soni
Urologist
5 yrs exp
Chennai
Plz consult
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Dr. Gautam Chopra
Urologist
17 yrs exp
Jalandhar
Consult for discussion and treatment
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Dr. Praveen Kumar Lakhera
Urologist
18 yrs exp
Jabalpur
Consult to urologist for further management
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.