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Flic

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Saturday, January 23rd 2010, 1:19pm

Sterile Pyuria???!!

Hello??

Can anyone shed any light on this??

I've had ++leukcytes in urine for a while and the seniour mw at my CTG yesterday asked if I'd been on antibiotics (which I haven't) and then I had to do a massive urine sample.

Then in my care plan she's writen Urine sent for 'Sterile Pyuria'. But I have no idea what this means!!

Help!!






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Saturday, January 23rd 2010, 2:06pm

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...Sterile pyuria is the presence of elevated numbers of white cells (>10/cubic mm) in a urine which appears sterile using standard culture techniques:.

•Often found in female patients with symptoms of urinary tract infection and presence of pyuria but no bacterial growth can be cultured. However, these results may be misleading for various reasons:
◦Standard laboratory culture conditions may not be optimal for growth of atypical organisms.
◦Laboratory may not report significant growth either because it was not a single organism or recognised urinary pathogen.
◦Less than 100,000 colony-forming units (cfu) per ml reported, e.g. may be urine was diluted by high fluid intake or organism may be slow growing. Studies have shown that approximately half of women presenting with symptoms and counts of 100 -10,000 cfu/ml have genuine bladder infections.
•Presence of pyuria increases significance of a low bacterial count.
•Cell count per high power field is inaccurate and use of counting chamber or similar gives more accurate results with 10 white cells/mm3 being diagnostic of infection.
.Causes of sterile pyuria
•A recently (within last 2 weeks) treated urinary tract infection (UTI) or inadequately treated UTI
•UTI with 'fastidious' organism (an organism that grows only in a specially fortified artificial culture media under specific culture conditions) e.g. N. gonorrhoea
•Renal tract tuberculosis, chlamydial urethritis
•False negative culture due to contamination with antiseptic
•Contamination of sample with vaginal leucocytes
•Interstitial nephritis: analgesic nephropathy, sarcoidosis (lymphocytes not neutrophils)
•Urinary tract stones
•Renal papillary necrosis: diabetes, sickle-cell disease, analgesic nephropathy
•Urinary tract neoplasm
•Polycystic kidneys
•Interstitial cystitis
•Prostatitis
•Other reported associations include appendicitis, systemic lupus erythematosus and Kawasaki disease
.Epidemiology
Sterile pyuria is common.1.

.Presentation
•UTI: severe dysuria, frequency, urgency, urge incontinence, haematuria, constant suprapubic discomfort, non-specific malaise.
bab22

Steffani






jilly

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Saturday, January 23rd 2010, 2:08pm

It mentions leucocytes as a cause, so i would imagine they are just making sure u havent got this because uv had leucocytes in ur urine and it can lead to this.

Hope its helpful.
xxx
bab22

Steffani






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Saturday, January 23rd 2010, 2:50pm

Hi Flic,
Sterile = no signs of bacteria
Pyuria = presence of white blood cells (or leucocytes) in the urine

There are many causes of this, and it is common in pregnancy. They probably will just keep an eye on it, and it is absolutely nothing for you to worry about.

If you do experience any symptoms of a wee infection (burning when you wee, going even more frequently, ache in your side, or just feeling off colour) let your midwife know. And whenever you see a midwife, always take a wee sample with you or ask for her to check your wee. (She probably will automatically do this anyway).


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Flic

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Saturday, January 23rd 2010, 5:26pm

Hiya!

Thanks for this. I've not got any symptoms but I have had an ache in my back for a while. I think I put a thread on a while ago, but they've just said that everything is fine.

I don't think there's anything wrong with me, I need to pee lots but I thought that was just pregnancy!

And I definately don't have appendicitis (I don't have an appendix!!)

I know there was 1 + and now there's 2 + in my care plan so I don't know whether that means there's a bit more of it??!!

I'll find out on Wednesday I think when I go back.






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Saturday, January 23rd 2010, 9:47pm

Hi Flick

1+ means there are scanty white blood cells in your urine, 2+ means there are moderate white blood cells and 3+ means numerous wbcs (I'm a biomedical scientist in a microbiology lab).

It's prob nothing to worry about hun, but they may try culturing your urine using some extra culture media and growth conditions just to make sure it's not being caused by a more unusual microorganism. I wouldn't worry about it if you're not having any symptoms though!

Good luck with the rest of your pregnancy! We've never spoken before but I've read some of your posts on here and I'm really excited and happy for you as you seem like such a lovely person

xx

Flic

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Sunday, January 24th 2010, 9:59am

Thanks Stephanie!!! I now know what the +'s mean!!!

I'm guessing that this is why I had to pee loads for them then. But I'm not having any symptoms of anything so I'll not worry about it.

Thanks for the good luck! I need it!!

And thanks for the information!!

xxx






Our miracle was born on 25.02.2010!!



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