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Pus Cells and No growth of bacteria

Hi there everyone,
am hoping that someone here is able to answer this question.  Sorry this is so long, I guess the history was not that brief...lol

Brief history but I am sure some forum friends have been following this.

I have had really, really bad burning in my privates for the last 5 weeks, chronic and on going.  Originally I thought I had a UTI,  Dr tested urine in his rooms, blood, protien and leukocytes were present, he also thought the same, I was placed on antibiotics, given a double script.  Took tablets with NO RELIEF, so took second lot, still NO RELIEF, many other neurological symptoms present too.  Went back to GP who tested urine again and thought it might be a resistant strain so sent to lab, the blood, protien and leukocytes were all present still. Did not prescribe antibiotics as he didn't want to give me the wrong ones until lab results come back... YEP THEY CAME BACK normal, I didn't grow anything but from what he is telling me now I had pus cells in it.

He decided it was most likely neurological and I guess he thought I might have cross contaminated the sample.  I increased my gabapentin (tripled the dose) with no joy there either but I must admit it has helped my other neuro symptoms a bit.. I went back as although I think some of my probs are neuro possibly caused by an infection or whatever is wrong I still felt I AM NOT RIGHT.  I had the same thing protien, leuckocytes and blood so sample went back off to lab well my Dr rang me this time sounding more concerned and said that there is pus cells but I haven't grown anything so I have just provided another sample that had to be super clean, mid stream etc.

I have had some probs with urinating, like I don't feel that it starts properly and i feel like i am not empying proplery, I put this down to the TM stuff as I have had bladder issues in the past but now I am not so sure, or is it my bladder stuff from the TM that is causing the pus cells because I am not emptying properly?

My Dr put me on amitryptiline to help with my burning but I haven't taken it yet as I was waiting now for this next lot of lab results.

WHAT DOES all this mean?

Cheers,
Udkas,
16 Responses
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751951 tn?1406632863
I did!  I figured I might learn something!

Hey, shaky, thanks for your concern, if it was in reply to the post directly above yours.   Yes, I am way better in that aspect.  It was a plumbing problem, purely structural in origin.  Still a long story.

If you meant your reply to Udkas, memory is uncertain, but I don't believe she is likely to have a prostate problem.

God bless!

Helpful - 0
1 Comments
Hi. My urine analysis showed puss in urine. But the culture came back fine? What I've read up on this is that it is yoyr body fighting infection. And now that iam in 40s tons of repeat problems with utis bacteria infections. I've even reduced my caffeine and drastically to no avail and took vaginal probic. Same parenteral gor several yesrs. Is there any help for me out there?
Avatar universal
this is a "years old" thread!  most people won't even read down to your reply!
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Avatar universal
This sound like a prostate issue....   r u better?
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751951 tn?1406632863
Sorry, luv & Lu, and everyone else; I did mean urologist.  I am so used to writing neurologist, and usually functioning on less sleep than I'd like.

Quix, I hope you're feeling better; the depth and clarity of your answer would lead me to suspect that to be the case.  You are a treasure, young lady.  May God bless you and all who matter to you.

Udkas, I will pray that you find relief very soon.  Little has given me so much distress as the whole kidney-and-bladder-and-the-plumbing-between system.  Fortunately, since my 1986 surgical experience, I've only had one serious stone problem.  The 1986 episode began in 1983, though.  Sometime when I'm alert and have time, I'll write up the gory details of that for everyone's amusement.  It's a doozy.

Peace and blessings to all.
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Avatar universal
Thank you for your information, it was and is incredibly informative and I think last time my Dr was or seemed quite concerned so I am expecting to get some tests happening if this pathology sample brings the same result.  I will know tomorrow.

I am feeling utterly miserable, I am just burning like mad, I don't actually have pain urinating but I know I am not right in that area, just can't explain it.

I keep running temperatures on and off and when my temp goes up my pain in my privates is worse, i suspect this is what is causing my temp. but I have now gone and got a very bad cold and my glands in my throat are like golf balls.

I have never had my husband look at what I write on this forum and what people write back etc., he is aware that I go on this forum  and is supportive to me and what I do on this forum, but I have just showed him this entire thread so he could see the type of support i receive.  He is grateful to you all too.

TO QUIX

Quix your info was wonderful and I promise I will remain open minded, I am not the type to jump to conclusions and self diagnose but I KNOW THERE IS SOMETHING WRONG and I have had ENOUGH!  I will become AGGRESSIVE with my GP if I don't get some help soon.. as I am becoming very miserable and I am getting worse.. this type of stuff is likely to cause another flare if not already.

Thanks again to everybody.

Cheers,
Udkas.
Helpful - 0
147426 tn?1317265632
What you are describing is called "sterile pyuria" and "sterile hematuria" with proteinuria.  You can probably guess that when you put "-uria" on the end of something it means "in the urine".  Also sterile refers to nothing growing on culture of the urine.  This needs to be worked up aggressively (read that AGGRESSIVELY).  You need a cathed urine or a really, really clean catch.  this is to show that the pus cells, blood and protein are not from another location like the vagina or an abcess close by.

Everybody is right.  You also need a referral to a Urologist.  These are the plumbing doctors.  A nephrologist deals with the very complex workings of the kidney itself, as it filters out toxins and waste products from the body.  You may need a look-see inside the bladder, called a cystoscopy.

One of the first things you need done is an ultrasound of the kidneys.

Now, what could this be?  You have gotten good answers.  Yes, this could be a large stone higher in the pipes near the kidney.  This can cause a blockage and end up damaging the kidney as Dan says.

The words "sterile pyuria" immediately bring up one thing in a phsycian's mind.  It sounds foreign and impossible, but tuberculosis of the urinary system is a major cause of this, even now.  Your doctor should collect the first am void for three mornings and send it for TB culture, called acid-fast bacteria culture.  this is treatable, but it has to be found first.  You should have a TB skin test, called a PPD and maybe a chest X-ray.

Also there are other organisms that won't grow on a standard culture - like atypical bacteria (eg. Chlamydia) or fungal infections.

When there is blood in the urine one has to think of kidney disease itself.  So you should have a blood test to look at your renal function.  This should definitely include a BUN and creatinine found in a basic chem panel.  The doctors should decide if you need a creatinine clearance test to see if your kidneys are functioning normally.  Also you need a full urinalysis to look for abnormal cells called casts and also for crystals.  At any time have you had a strep infection and had dark urine (like cola)?

Other things that need to be ruled out include a cancer in the urinary system.  Your urine needs to be spun down and sent for "cytology" (the study of cells) to look for abnormal cells.  This would be less common, but can also be a cause of sterile pyuria and hematuria.

Blood in the bladder can cause nasty bladder spasms, which may be part of your discomfort.

Sometimes one can continue to have pus and blood in the urine after a treated bladder infection, but this should go away with a couple weeks max.  There are also things like a lowgrade abcess in the appendix that is adjacent to the bladder causing an inflammation in the bladder, but will also be sterile.  All urine is (or is supposed to be) sterile as long as it is inside the body.

So you can see that this is not something that we "sit on" so to speak.  We know the things that cause this and we know what to do.

Important and these are things your GP should be ordering:

Blood tests to look at renal function.
Kidney ultrasound
Urine cytology
Full Urinalysis with microscopic
PPD
Urine for culture of acid-fast bacteria, atypical bacteria, and fungal infections.

Referral to Urologist unless the renal function tests or ultrasound are abnormal - then referral to a Nephrologist.  Man, this is basic medicine and stuff I did all the time.  It is not rocket surgery!

I hope this helps.  Remember, I told you about all that it "could" be.  Most of those things are not common, but sterile pyuria/hematuria/proteinuria is NOT normal.

Quix
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Avatar universal
Thank you, Lulu...that's the one I couldn't spell:o).
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572651 tn?1530999357
PD - do you mean NEPHROLOGIST - the doctor who specializes in kidney disease?
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Avatar universal
Do you mean neurologist, urologist or kidney specialis (can't spell the official name)?
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751951 tn?1406632863
Having had kidney stones with extreme complications in the past, I would simply say that anything you can do to protect those God-given purification systems is well worth whatever effort might be necessary to GO SEE A NEUROLOGIST.  Trust me.  You don't want that pain.
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Avatar universal
Please don't feel guilty or like you are whining!!!  You probably feel absolutely horrible!  I know that I did when I had the experience that I wrote about last time.  Please do not delay getting to a urologist if you can help it.  You need one now.  Kidney infections can be dangerous.....any infection going on too long can be dangerous. You need to know what is going on and get help so you can get better.  I hope that happens for you very soon.  (((((Hugs))))))
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Avatar universal
Hi there,
I really do appreciate your comments.  all this is starting to get to me!  If I don't get a result on Monday with the new lab tests I think I will push for further testing and to got a urologist as I am fed up and getting miserable and depressed, it has been going on too long with no relief!

I really do appreciate everyone's comments and support as I feel like I have been whining and whinging all the time and admit I feel a bit guilty about it all.

Thanks again, I will update on Monday.

Cheers,
Udkas.
Helpful - 0
562511 tn?1285904160
Hi.  Warning:  subliminal messages are contained within this message.

A couple of thoughts.  With all of the burning and numbness in your privates and other areas, please consider that you are possibly not feeling pain in the usual manner. It would be difficult to pinpoint a particular area that is causing pain that could better point in the direction of your problem.  Luverofrogs makes a good point of the possibility of other causes than a typical UTI. *go to a urologist*

An infection of the urinary tract is one thing, but an infection that makes it's way up to the kidneys is another.  You have to make sure this is not happening because it can make you VERY sick and could compromise your kidneys.  *go to a urologist*  

You have been dealing with this urinary problem and possible infection for too long. *go to a urologist*  A "clean catch" should have been done a long time ago.  *go to a urologist*
I don't think anyone would dare make a guess of what is causing the blood, pus, and WBC's to be in your urine without proper testing.

At this point, you should see a urologist as soon as possible.  Ask around, maybe you can find one that is knowledgeable in helping folks with their neurogenic bladders.  Have you told your neurologist that you are having difficulty resolving the infection that's not there scenario?  I'll bet he/she could refer you to a good urologist.  *go to a urologist*

In the meantime, you might try taking a low dose of the amitryptiline.  I don't see how it could hurt.  Should help you in relieving the pain and burning.  You have suffered long enough with it, wouldn't you say?  *go to a urologist*  Relief could be right around the corner.  With all the sensory problems you are having, you may not be able to feel if your bladder is ready to burst. Having protein in your urine is not something to ignore.  

Get to feeling better soon.  Oh, did I forget to say you should see a urologist?  
  


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Avatar universal
A few years ago, I had a massive UTI that wasn't found for months despite repeated testing with me giving samples and medical staff doing caths.  I had blood in my urine for months.I had protein and some other things that I don't remember too. Antibiotics didn't work after several rounds for me either.  I ended up peeing dark purple colored urine before it got serious attention. I had a kidney ultrasound because my dr was worried about kidney function with some of the things found in the urine test at that point.  The tech didn't find anything.  I later had a CT scan that showed a huge kidney stone. I had a very serious kidney infection.  The urologist did a bladder scope and said my bladder was normal.  I had surgery to blast out the stone and was put on the strong antibiotics again.  That finally did the trick.  I really feel for you!!!!  If you are not seeing a urologist, you may seriously want to find one.  If you haven't been tested for stones, that would be a good idea too.  Whatever the problem is, I hope that it's found very, very soon and that you get help and feel better asap:o).
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405614 tn?1329144114
I can't believe they haven't figured this out yet and found a way to help you.  I'm so sorry.

I'm sorry I have no answers for you, just sympathy and hopes for answers and relief.

Hugs,

Kathy
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572651 tn?1530999357
I feel like I should know this answer but I don't - is this doctor your GP/PCP or is he a urologist?

If he is not a urologist I think you need to be seen by one.  

The big danger of not emptying the bladder completely is having urine back up into the kidneys and cause big problems.  If that would include your symptoms, I really don't know.  

To me pus = infection - period.  Just the mere problem of being a neurogenic bladder would not create pus.
I'm sure someone else will have a more scientifically sound answer for you.

be well,
Lulu

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