# Pyuria > Mediated Wiki article. Canonical URL: https://mediated.wiki/source/Pyuria > Markdown URL: https://mediated.wiki/source/Pyuria.md > Source: https://en.wikipedia.org/wiki/Pyuria > Source revision: 1344841962 > License: Creative Commons Attribution-ShareAlike 4.0 International (https://creativecommons.org/licenses/by-sa/4.0/) {{Short description|Presence of pus in urine}} {{distinguish|Pyorrhea}} {{Infobox medical condition (new) | name = Pyuria | image = Pyuria.JPG | caption = White blood cells seen under a microscope from a urine sample. | pronounce = {{IPAc-en|ˌ|p|aɪ|j|ʊəˈr|iː|ə}} | field = | synonyms = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} '''Pyuria''' is the condition of [urine](/source/urine) containing white blood cells or [pus](/source/pus). Defined as the presence of 6–10 or more [neutrophils](/source/neutrophils) per high power field of unspun, voided mid-stream urine, it can be a sign of a bacterial [urinary tract infection](/source/urinary_tract_infection). Pyuria may be present in people with [sepsis](/source/sepsis), or in older people with [pneumonia](/source/pneumonia). Others additionally require discoloration, clouding or change in the smell of urine for a '''pyuria''' to be present. Without these additional features, there is said to be '''leukocyturia'''. '''Sterile pyuria'''{{cite journal | title =Sterile Pyuria | journal =N Engl J Med | date =March 12, 2015 | author =Gilbert J. Wise | author2 =Peter N. Schlegel | name-list-style =amp | volume =372 | issue =11 | pages =1048–1054 | doi = 10.1056/NEJMra1410052 | pmid = 25760357| doi-access =free }} is urine which contains [white blood cells](/source/white_blood_cells) while appearing sterile by standard [culturing](/source/Microbiological_culture) techniques. It is often caused by sexually transmitted infections, such as gonorrhea, or viruses which will not grow in bacterial cultures. Sterile pyuria is listed as a side effect from some medications such as [paracetamol (acetaminophen)](/source/paracetamol). Its occurrence is also associated with certain disease processes, such as [Kawasaki disease](/source/Kawasaki_disease) and genitourinary [tuberculosis](/source/tuberculosis). However, there are many known causes, including [systemic](/source/Systemic_disease) or [infectious](/source/Infectious_disease) disease, structural and physiological reasons, intrinsic kidney pathology, or drugs.{{cite journal |author=Dieter RS |title=Sterile pyuria: a differential diagnosis |journal=Compr Ther |volume=26 |issue=3 |pages=150–2 |year=2000 |pmid=10984817 |doi= 10.1007/s12019-000-0001-1|s2cid=11629600 }} ==Leukocyturia== Under normal conditions, fewer than two million leukocytes are expelled in urine per day. A number greater than two million is called leucocyturia and can be determined when determining the [Addis count](/source/Addis_count).{{cite book |last=Vasan, R.S. |date=1998 |title=Textbook of Medicine|url=https://books.google.com/books?id=qLZHaBf9l7YC&q=leukocyturia+3+million&pg=PA939 |publisher=Orient Blackswan |page=939 |isbn=9788125012665 }} However, this method requires a 24-hour urine collection, so it is not practical. Currently, the number of leukocytes is estimated under the microscope for which morning urine is taken. It has been arbitrarily assumed that a number of over 4-5 leukocytes in the field of vision of the microscope indicates leukocyturia.{{cite book |last=Bagga |title=Urinary Tract Infections And Anomalies|year= 2009|url=https://books.google.com/books?id=HjBu2m_Gx-MC&q=%22Leukocyturia%22+-wikipedia&pg=PA4 |publisher=Elsevier Health Sciences |page=4 |isbn= 9788131223710}} At the moment, there are also quick test strips available, allowing after wetting a special diagnostic bar, the detection of granulocytes in the urine, as evidenced by the color change of the test strip.{{cite book |first1=Walter |first2=Johannes |first3=Georg |last1=Hofmann |last2=Aufenanger|last3=Hoffmann |date=2016 |title=Laboratory Diagnostic Pathways: Clinical Manual of Screening Methods and ... |url=https://books.google.com/books?id=KOAXDQAAQBAJ&q=%22Leukocyturia%22+-wikipedia&pg=PA142 |publisher=Walter de Gruyter GmbH & Co KG. |page=142 |isbn= 9783110455083}} The principle of their operation is based on the detection of [granulocyte](/source/granulocyte)s [esterase](/source/esterase)s, including leukocytes. This method, however, is burdened with a large number of false positive results (use of [antibiotic](/source/antibiotic)s, such as [imipenem](/source/imipenem), [meropenem](/source/meropenem), [clavulanic acid](/source/clavulanic_acid), which is sometimes combined with [penicillin](/source/penicillin) derivatives) or false negative ([gentamicin](/source/gentamicin), [cefalexin](/source/cefalexin), [glycosuria](/source/glycosuria), [proteinuria](/source/proteinuria)).{{cn|date=April 2021}} Leukocyturia is a laboratory symptom of many diseases like [glomerulonephritis](/source/glomerulonephritis) or [pyelonephritis](/source/pyelonephritis). It may occur in the case of diseases of the urinary tract, reproductive system and diseases of the abdominal organs.{{cite book |first1=Manfred Schmidl |last1=Von Forstner |date=1986 |title=Laboratory testing in veterinary medicine diagnosis and clinical monitoring|url=https://books.google.com/books?id=VPlUAAAAYAAJ&q=%22Leukocyturia%22+-wikipedia |publisher=Boehringer Mannheim |page=20 }} Leukocyturia is mostly a sign of [urinary tract infection](/source/urinary_tract_infection), especially if significant bacteriuria is found (for most people, the number of bacteria in a culture is > 10^5) and other symptoms associated with passing urine.{{cite book |date=2000 |title=Archives of Medical Research, Volume 31|url=https://books.google.com/books?id=VStgAAAAMAAJ&q=%22Leukocyturia%22+-wikipedia |publisher=Instituto Mexicano del Seguro Social |page=214 }} The presence of leukocyturia does not indicate the need for antimicrobial therapy yet.{{cn|date=April 2021}} ==Additional images== [[File:Pyuria2011.JPG|thumb|left|Pyuria in a person with [urosepsis](/source/urosepsis)]] {{clear}} ==See also== * [Urinalysis](/source/Urinalysis) * [Bacteriuria](/source/Bacteriuria) ==References== {{reflist}} == External links == {{Medical resources | DiseasesDB = | ICD10 = {{ICD10|N|39|0}} | ICD9 = {{ICD9|791.9}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = D011776 | SNOMED CT = 4800001 }} {{clear}} {{commonscat|Pyuria}} Category:Medical signs Category:Symptoms and signs: Urinary system {{med-sign-stub}} --- Adapted from the Wikipedia article [Pyuria](https://en.wikipedia.org/wiki/Pyuria) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Pyuria?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.