What is Sterile Pyuria in Urine Test? Definition and Findings

Read all about sterile pyuria in urine. Learn more about definition and causes of sterile pyuria. Currently no agreed definition for Sterile Pyuria exists. It is simply the presence of white blood cells within the urine, in the absence of infection.

Sterile pyuria is a highly prevalent condition, and population-based studies show that 13.9% of women and 2.6% of men are affected. Specific populations have a higher risk of this condition; for example, the frequency of detection of sterile pyuria was 23% among inpatients in one study (excluding those with urinary tract infection), and sterile pyuria is more common among women than among men because of pelvic infection. Subsequent to initial detection, the costs of laboratory, radiographic, and invasive evaluation in such large populations can have a considerable effect on health care expenditures.

Sterile pyuria, the condition of increased puss cells in the urine, can be an indication of more serious conditions going on within the urinary tract. Most often a sign of infection within the kidneys or bladder, too many puss cells in the urine can mean a urinary tract infection, a sexually transmitted disease, kidney infection, or abscess near the kidney. Pyuria may also be a sign of stones in the urinary passage.

In the present case, the acute onset of acute sterile pyuria without any fever, pain or dysuria is a big challenge. The acute condition implies low possibility of chronic condition such as tuberculosis and cancer. The relationship between occurrence of problem and ciprofloxacin treatment is the clue for first diagnosis.

Sterile pyuria can pose a real diagnostic challenge for clinicians and the allied healthcare team. The sterile pyuria is an interesting problem in urology. Acute gross sterile pyuria is not a common clinical problem and is difficult to make a correct diagnosis. Here, the authors reported a case of acute gross sterile pyuria after oral ciprofloxacin treatment of urinary tract infection. The patient developed problem after complete course of 7-day acute upper urinary tract treatment. The patient was observed with cloudy whitish urine that had never seen before. The urinalysis showed sterile pyuria. This case was treated by conservative method and the problem was resolved within 7 days.

What is Sterile Pyuria in Urine Test Definition and Findings

What is Sterile Pyuria in Urine Test?

Sterile pyuria is potentially misleading, as the commonest cause for the finding is undoubtedly infection of some sort. This may be a partially treated urinary tract infection (even one dose of antibiotic before urine collection), a recently treated UTI (pyuria often remains for one-two weeks after clearing infection), a UTI with fastidious or slow growing atypical organisms that fail to grow during standard laboratory culture, or a sexually transmitted infection, particularly chlamydia in the asymptomatic sexually active person. Sterile pyuria has historically been considered to be suggestive of genitourinary tuberculosis, but a wide variety of other causes must be considered.

Sterile Pyuria Definition

Sterile pyuria can be broadly defined as the presence of leucocytes in the urine in the absence of demonstrable urinary tract infection. It is a relatively common problem, with a wide range of causes, encountered frequently in both primary and secondary care settings, although there is no data to suggest the estimated prevalence in either a community or hospital setting. Indeed, the medical literature, in all its vastness, contains remarkably little research or guidance regarding this problem, leaving many primary care physicians in the dark as to how best to manage their patients. This results in inconsistent management, ranging from ignoring the finding completely to over investigation and possibly unnecessary secondary care referral.

Sterile Pyuria Findings

Sterile pyuria (SP) is not an uncommon finding in. Nine per cent of patients presenting to their GP with lower urinary symptoms, and who are suspected of having urinary tract infections (UTIs), are found to have sterile pyuria. It continues to pose a diagnostic conundrum to physicians, as well as to allied healthcare professionals (HCPs), because there are no guidelines on its management. For management, antibiotic treatment is indicated. However, in some cases, there is no pathogen and the bacterial infection can be ruled out.

The condition of sterile pyuria is usually a challenge in clinical management. The problem can be due to several conditions such as tuberculosis, cancer and inflammation. Physical findings in pyuria depend on the underlying cause of the condition. Bladder infection (cystitis) can usually be diagnosed from the individual’s history and symptoms. In general, there are no abnormal findings on physical examination. Individuals with a kidney infection (pyelonephritis) may have fever, tenderness in the region of the back over the kidneys (cost vertebral angle), and kidney enlargement.

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