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Pyuria translates as pus in the urine, which really means there is a higher than expected concentration of white blood cells in a person’s urine. There are numerous reasons why this condition can occur. The underlying diagnosis can mean symptoms of this high white blood cell count in urine could be vastly different.
To diagnose high white blood count, the most common test is a urinalysis. People give a urine sample, typically simply by urinating in a sterile cup or other collection device, and laboratories evaluate it in numerous ways. Should they find white blood cell count to be very high, which often makes the urine look cloudy or milky, the lab would then inform the doctor who had 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 urinary tract infection (UTI), which can afflict the bladder, kidneys or other parts of the urinary tract. A high presence of white blood cells can say the body is using its natural defenses to fight the infection. The main treatment for a UTI is antibiotics, which can aid in the fight to destroy bacteria.
There are other bacterial infections that might be indicated by pyuria. People with certain sexually transmitted diseases like gonorrhea or chlamydia may sometimes get infections in the urinary tract as a result. Other illnesses like tuberculosis may cause bacteria to proliferate in the kidneys or bladder, and might result in high white blood cell count in the urine.
Sometimes stones in the bladder, ureter, or kidney elevate white blood count. Alternately, enlargement of organs or structures in the pelvic region create a white cell chain reaction observable in urine. Even some parasitic infections, like trichomoniasis, may result in urine being affected and the condition can be found in a patient with pneumonia.
Given the many causes of the condition, doctors may not fully rely on this test for complete diagnostics. While it is an indication that something is wrong, it doesn't identify the cause. Sometimes other physical findings upon examination lead doctors directly to an accurate diagnosis, but in other cases, doctors will need to perform other tests or examinations to determine what the finding of pyuria really means. There are clear-cut cases, where the findings simply suggest a UTI, which can be treated with antibiotics, but other patients might need additional testing to get a more accurate diagnosis of the underlying cause.
The wide range of potential causes suggests it may be hard for people to know if they’re ill. Some signs of possible pyuria are milky or cloudy urine and indications of infection, such as fever. Unfortunately, people with straightforward illnesses like bacterial urinary tract infections are often asymptomatic, and may not notice any difference in urine appearance.