blood in urine- no puss cells

[Laura__0__0]

  Sunday Morning I woke with a fever of about 102 degrees.  My throat was soar, and my head hurt.  i did not worry too much, just thought i was coming down with a cold, or sinus infection.  since then, the fever never subsided, and my throat became more soar.  i saw a nurse practitioner yesterday.  i told her that i had frequent urinary tract infections, and several kidney infections. i had noticed an increase of trips to the restroom to urinate, and it seemed to have an odor.  but it didn't seem as if i had a uti. she dipped my urine, and said that it had alot of blood (not visible to without microscope) but had no puss (white cells).  she really didn't know what the problem was.  they also cultured my throat, and it came up negative to strep.  so now i am very worried after reading all about this bladder cancer. I am a 24 female with two children, and have only been with one man.
  The Nurse Practioner put me on two different antibiotics;  Ceftin 250mg and entex pse.
  Should i be seeking the advice of a urologist as apposed to a N.P.?  I am very worried.  Please respond as soon as possible.
  Thanks,
  Laura

[HFHS M.D.-BE]

Dear Laura,
The presence of microscopic blood in your urine and your fever may be coincidental and unrelated.  The odor of urine could be due to concentrated urine, resulting from dehydration secondary to your high fever, which may have been caused by an upper respiratory process which you described.  The history of chronic urinary tract infection (UTI) and kidney infections is a concerning problem, which should be fully evaluated by a urologist.  You may have blood in your urine at all times and it was only discovered incidentally when you went to the NP.  There are a multitude of causes for microscopic blood in the urine, and UTIs, which may have a connection.  The absence of pus in your urine (when the NP checked it) decreases the likelihood of an active UTI.   It is unlikely at your age that you would have a cancerous or malignant cause for the presence of blood in your urine.  It is likely, however, that you may have a specific cause for chronic infection, such as a kidney stone that as yet is undiscovered or diagnosed.  This could also cause there to be blood in your urine.  A urologist is absolutely the specialist who can best evaluate your symptoms.  The workup would include:
IVP (radiologic study of the kidneys with contrast medium)
cystoscopy (looking into the bladder with a scope, through the urethra)
urinalysis  
urine cytology (checking the cells present in your urine).
It is crucial that you see a urologist to get to the bottom of your urinary troubles.  The medicines your NP put you on were one antibiotic, the Ceftin, which could have treated a UTI, if you had one, and Entex, which is a decongestant, not an antibiotic.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BE
*keyword: microhematuria