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Thread: Leukocytes in urine but no infection....

  1. #1

    Leukocytes in urine but no infection....

    female, suprapubic catheter, no stones, no bateria (C&S), recent scan of kidneys all clear BUT persistent leukocytes (sometimes with blood and protein, sometimes without). Other symptoms include severe spasms, general UTI-feeling, high temperatures, floaty bits in urine.

    2 C&S reveal no bateria.

    What else could be causing leukocytes & UTI-esque symptoms?

    Many thanks for any possible insights.

  2. #2
    Has your Dr ruled out urethritis?

  3. #3
    Quote Originally Posted by Tayberry View Post
    female, suprapubic catheter, no stones, no bateria (C&S), recent scan of kidneys all clear BUT persistent leukocytes (sometimes with blood and protein, sometimes without). Other symptoms include severe spasms, general UTI-feeling, high temperatures, floaty bits in urine.

    2 C&S reveal no bateria.

    What else could be causing leukocytes & UTI-esque symptoms?

    Many thanks for any possible insights.
    What levels (counts) of leukocytes (White Blood Cells-WBC) have you experienced? Is the urine cloudy? have no odor?

    Since you have had recent tests and scans, has your physician posited a diagnosis or reason for your symptoms or has he just left things up in the air?

    Have you had other tests done to rule out infection elsewhere in the body, diabetes?

    Do you take anticholinergic medications, i.e., oxybutynin for bladder spasms?

    All the best,
    GJ
    Last edited by gjnl; 08-12-2012 at 03:56 PM.

  4. #4
    What type of catheter are you using? Some are more irritating to the bladder mucosa than others, and this irritation can trigger the migration of white blood cells into the bladder and urine. I assume your scans included not just the kidneys, but the ureters and bladder as well? Is your blood WBC count normal?

    What type of catheter (material) are you using? Some are more irritating than others.

    (KLD)

  5. #5
    Quote Originally Posted by Craig80 View Post
    Has your Dr ruled out urethritis?
    I'll enquire about this. Thanks.

  6. #6
    Quote Originally Posted by gjnl View Post
    What levels (counts) of leukocytes (White Blood Cells-WBC) have you experienced? Is the urine cloudy? have no odor?

    Since you have had recent tests and scans, has your physician posited a diagnosis or reason for your symptoms or has he just left things up in the air?

    Have you had other tests done to rule out infection elsewhere in the body, diabetes?

    Do you take anticholinergic medications, i.e., oxybutynin for bladder spasms?

    All the best,
    GJ
    Despite massive water intake, my urine is not clear. It's not super cloudy but not clear either. Also, it has a slight smell.
    I'm measuring my leukocyte level at home using dipsticks. It always reads 'small +' or 'moderate ++'. I will see if my Dr can run a more specific set of tests to see which type of WBC is present. My Dr has not suggested any possible reason for my symptoms.

    Full blood count (FBC) was normal, as was kidney function.

    Vesticare 5mg daily.

    Thanks for your input. Apart from trying to find out what's causing the WBC I'm not sure what else to do. Anything I'm missing??

  7. #7
    [QUOTE=SCI-Nurse;1567142]What type of catheter are you using? Some are more irritating to the bladder mucosa than others, and this irritation can trigger the migration of white blood cells into the bladder and urine. I assume your scans included not just the kidneys, but the ureters and bladder as well? Is your blood WBC count normal?

    What type of catheter (material) are you using? Some are more irritating than others.

    I'm using 'Bard Biocath Aquamatic Hydrogel Coated Latex'.
    Scan was of bladder, ureters and kidneys and I forgot to mention I had a cystoscopy which was all clear. Recent FBC was normal.
    Thanks for your help. Anything else I should be asking my Dr about? I'm seeing my urologist on Wednesday - any suggestions?

  8. #8
    Dipstick tests for WBC are not really valid as a criteria for diagnosing UTI for someone who uses a long term, chronic indwelling catheter. Neither is odor or cloudiness.

    Signs and symptoms that are important include fever, chills, flank pain, leaking around the catheter, autonomic dysreflexia, WBC elevation (in the blood, not urine), and severe malaise. If you treat based on dipstick results (an indication of colonization only) you will end up continuously chasing and over treating, and putting yourself at risk of developing resistant strains of bacteria that cannot be easily treated when you have a true UTI.

    (KLD)

  9. #9
    Quote Originally Posted by SCI-Nurse View Post
    Dipstick tests for WBC are not really valid as a criteria for diagnosing UTI for someone who uses a long term, chronic indwelling catheter. Neither is odor or cloudiness.

    Signs and symptoms that are important include fever, chills, flank pain, leaking around the catheter, autonomic dysreflexia, WBC elevation (in the blood, not urine), and severe malaise. If you treat based on dipstick results (an indication of colonization only) you will end up continuously chasing and over treating, and putting yourself at risk of developing resistant strains of bacteria that cannot be easily treated when you have a true UTI.

    (KLD)
    Couldn't agree more! I get what you are saying but I've already had a C&S done and there is no bacteria. I'm just left wondering why I feel so rough with spasms, fever/chills etc, leukocytes in urine but no bacteria/infection. This obviously is not an infection, but I'm left wondering, what is it?

  10. #10
    Quote Originally Posted by Tayberry View Post
    Couldn't agree more! I get what you are saying but I've already had a C&S done and there is no bacteria. I'm just left wondering why I feel so rough with spasms, fever/chills etc, leukocytes in urine but no bacteria/infection. This obviously is not an infection, but I'm left wondering, what is it?

    My Dad does intermittent cath and frequently has leukocytes (alone) in his urine. I always wondered if others had this. I suspect it is due to chronic irritation and I wouldn't treat for a UTI based on this alone. But you sound sick. Something is clearly up.

    Sometimes when we suspect a UTI is coming (changes in urine/increased urge...) a dipstick shows really high leukocytes only. So at that point we start drinking more, just in case this is the earlier stages of a UTI. If things don't improve/get worse, we repeat a dipstick again. Often the UTI will present itself in another day or two.... or things resolve.

    But by the time my father has a fever/spasms.... that's an infection. No doubt. You likely have an infection brewing.... somewhere. Either an early UTI. Or an infection somewhere else...

    Make sure you check all your skin carefully, think about whether you could have a respiratory infection, GI infection, ear infection etc..

    So I would have a low threshold for repeating another urine culture if you continue to feel poorly. If it is still negative, ask your doc... where is my fever/infection coming from? That needs to be pursued if there isn't an obvious cause.

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