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White blood cells with no growth on urine culture.
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White blood cells with no growth on urine culture.

Hello. Just a bit of history on myself. I am a 29yo female & currently 31 weeks pregnant. I have suffered from chronic hypertension for the last 6 years. I am currently taking Procardia 60XL once per day and Lebatalol 100mg twice per day for the blood pressure. I am currently on bed rest for slowly increasing BP.
My situation is this....I have weekly prenatal visits due to being high risk and I give a urine sample at every visit. About 3 1/2 wks ago my urine test came back with trace protein, leukocyte esterase positive and 2-5 WBC'S per high power field with trace blood. I had no symptoms of a UTI but was put on a 7 day course of Macrobid to treat a UTI. The next week the tests were the same but the WBC's were now 5-10 and "few" bacteria so the doctor said he would culture the urine sample. It came back "no growth" so he told me there was no need to take the antibiotics. This past Saturday, I passed a kidney stone. I have had them before and it was not painful. The only reason why I knew I had one was because I felt a sharpness in my bladder and so I knew it was coming and strained my urine and the stone came out. The next Monday(10/15/07), I went to the doctor again. The urine sample came back trace protein again with leukocyte esterase. The MICRO test came back 10-25 WBC's, MODERATE bacteria and FEW epithelial cells. My obstetrician said that did not look good so he gave me ANOTHER 7 day course of antibiotics(Macrobid) and said he would culture the urine. Now, the confusing part for me(and my doctor does not seem to have an answer)....is why would I have 10-25 WBC's and moderate bacteria in my urine but NO growth on a culture? My doctor told me to continue the Macrobid just in case but now I am worried that my WBC's seem to keep going up every time I give a urine sample. Note as well that I am continually monitored for kidney function because of my hypertension and my tests are always normal(ie creatnine, BUN, etc etc)
Today when I was watching the Today Show on NBC, they were talking about the superbug Staph infection. I have suffered from skin boils a few years ago on the inside of my thighs and was treated with antibiotics for several months(not for a staph infection) but just in the past few weeks, I am starting to get boils on my inner thighs again.
1. Do you know what possible reasons there would be for no growth on the culture with WBC's and bacteria in urine?
2. Could there be some sort of relation with the skin boils and the fact that I have WBC's in my urine? I am concerned about a staph infection now.


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There is no guarantee that a urine infection would grow out on culture.  Thus, it is possible to have a UTI and a negative culture.  The WBCs would certainly suggest an infection, even in light of a negative culture.  

Imaging the kidneys can be done (with an ultrasound) if stones are suspected.

I am not aware of an association between skin boils and the WBCs in the urine.

I agree with continuing monitoring of the kidney function in light of the proteinuria and hypertension.

These options can be discussed with your personal physician or urologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com
3 Comments
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I have the same problem but really don't want to take antibiotics till they know what the bacteria is
any light on your problem
do you have the urge to urinate often
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Avatar_n_tn
Be sure you are getting a really, really clean catch mid-stream urine sample! This is not as easy as you think, especially being pregnant, on bed rest and so forth. Almost all the cultures we see from women like you have some skin/vaginal contamination. Maybe you could collect the next specimen at home, like right after a shower and avoid any skin contamination?
If the bacteria are normal skin/vaginal flora then they may not grow as fast or easily as the usual UTI pathogens. Another possibility is that your bacteria are what we call "bugs on drugs" that are supressed by antibiotics.
nan3 (microbiologist)
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A related discussion, WBC in urine without growth in Urine Culture was started.
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A related discussion, infection was started.
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A related discussion, What's the problem? was started.
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A related discussion, white blood cells in urine but no uti was started.
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I am 31 weeks as well, congratulations on the baby!

The blood in your urine definitely indicates a kidney infection. There are probably more kidney stones growing too. Have your doctor do an ultrasound so you can see what's going on and check for more stones. I would also ask if there is any other safe meds you can take for the kidney infection since this one doesn't seem to be working. Contact the doctor immediately if you feel pain in the lower left side of your back. This will help him to recognize the stones easier of they are present. Good luck and you are in our prayers. The best thing for both you and the baby is to not stress.
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