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What’s Pyuria?

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Pyuria is an increase in white blood cells in urine, which can be caused by various conditions such as urinary tract infections, STDs, kidney stones, and tuberculosis. A urinalysis is used to diagnose pyuria, but further tests may be needed to determine the underlying cause. Symptoms include cloudy or milky urine and indications of infection.

Pyuria translates as pus in the urine, which actually means that there is a higher than expected concentration of white blood cells in a person’s urine. There are numerous reasons this condition can occur. The underlying diagnosis may mean that the symptoms of this high white blood cell count in the urine could be very different.
To diagnose a high white blood cell count, the most common test is a urinalysis. People provide a urine sample, typically by simply urinating into a sterile cup or other collection device, and laboratories evaluate it in a number of ways. If they were found to have a very high white blood cell count, which often makes the urine look cloudy or milky, the lab would notify the doctor who ordered the test. Based on other findings and perhaps other tests conducted at the same time, doctors look for potential causes of the condition.

One of the most common causes of pyuria is a urinary tract infection (UTI), which can affect the bladder, kidneys, or other parts of the urinary tract. An elevated presence of white blood cells can mean that the body is using its natural defenses to fight the infection. The main treatment for a urinary tract infection is antibiotics, which can help in the fight to destroy the bacteria.

There are other bacterial infections that could be indicated by pyuria. People with certain STDs such as gonorrhea or chlamydia can sometimes get urinary tract infections. Other diseases such as tuberculosis can cause bacteria to overgrow in the kidneys or bladder and can cause a high number of white blood cells in the urine.

Sometimes stones in the bladder, ureter, or kidneys increase the white blood cell count. Alternatively, enlargement of organs or structures in the pelvic region creates a white blood cell chain reaction seen in the urine. Some parasitic infections, such as trichomoniasis, can also cause urine flu, and the condition can be seen in a patient with pneumonia.

Given the many causes of the condition, doctors may not fully rely on this test for a complete diagnosis. While it’s an indication that something is wrong, it doesn’t identify the cause. Sometimes other physical findings on the exam lead doctors directly to an accurate diagnosis, but in other cases, doctors will need to do other tests or examinations to determine what the pyuria result really means. There are clear cases, where the results simply suggest a urinary tract infection, which can be treated with antibiotics, but other patients may need further testing to get a more accurate diagnosis of the underlying cause.

The wide range of potential causes suggests it may be difficult for people to know if they are ill. Some signs of possible pyuria are milky or cloudy urine and indications of infection, such as fever. Unfortunately, people with simple illnesses such as bacterial urinary tract infections are often asymptomatic and may not notice any difference in the appearance of their urine.

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