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Urology (Expert Forum)
White blood cells with no growth on urine culture.
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
White blood cells with no growth on urine culture.
by fleab123, Oct 17, 2007 08:43AM
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.
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.
Doctor's Answer
by Kevin Pho, MD, Oct 17, 2007 08:53PM
, Oct 17, 2007 08:53PM
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
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
any light on your problem
do you have the urge to urinate often
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)