Which Signs and Symptoms Indicate Sterile Pyuria?

Introduction to Sterile Pyuria

Sterile pyuria is a medical condition characterized by the presence of an abnormal number of white blood cells in the urine without the concurrent presence of bacteria or evidence of infection. This perplexing condition raises concerns among healthcare providers due to its potential association with various underlying health issues. While sterile pyuria itself may not pose an immediate threat, its presence often serves as a diagnostic indicator, prompting further investigation to uncover the root cause and ensure appropriate medical management. Understanding the nuances of sterile pyuria is crucial for healthcare professionals and individuals seeking answers to urinary health concerns.

Depending on your specific condition, sterile pyuria can cause a variety of symptoms.

An increased concentration of white blood cells in the urine is a defining feature of the urinary condition pyuria. A high number, according to medical professionals, is 10 or more white blood cells per milliliter (mm3) of centrifuged urine. Urine affected by pyuria may seem hazy or pus-like. Pyuria is frequently seen when there is a urinary tract infection (UTI). Rarely, it may be a symptom of sepsis or a serious UTI.

Pyuria that doesn’t have any bacterial activity is referred to as sterile pyuria. In some situations, it might be connected to undiagnosed bacteria, a virus or other form of germ, or another underlying medical issue.

Discover the causes, signs, and possible treatments for pyuria in this article.

What You Need to Know About Pyuria

Causes or Symptoms

Risk elements




Pregnant women



A urine disorder called pyuria is linked to white blood cells. A urine test might be used by your doctor to diagnose this illness.

If you have at least 10 white blood cells per cubic millimeter of urine, your doctor will diagnose pyuria. This frequently denotes an infection. However, persistent white cell counts without bacterial infection show up during testing in sterile pyuria. This disorder has a wide range of causes and treatments. Find out more about pyuria, including how to treat and avoid it.


Pyuria’s most frequent cause is a urinary tract infection (UTI).

Other potential causes of pyuria include

sexually transmitted diseases (STDs), including chlamydia, gonorrhea, genital herpes, infection with the human papillomavirus, syphilis, trichomonas, and mycoplasma, as well as viral infections such as the adenovirus, BK polyomavirus, and cytomegalovirus

Cystitis interstitial

Bladder discomfort syndrome

Genital infections

Gastrointestinal infections



Nuclear cystitis

Obstructions in the urinary system

Mesh transvaginal

Urogenital fistulas

Internal renal conditions

Rejection of a kidney transplant

Polycystic renal disease due to TB

Ureteral stones

Mold infections

Autoimmune conditions like Kawasaki disease

Pyuria can also result from long-term usage of the following medicines:

Penicillin-containing antibiotics





Medicines that are non-steroidal and anti-inflammatory, like ibuprofen (Advil, Motrin)

Proton pump blockers


Among the signs of a UTI are:

Excessive urination

Urine with blood in it

Murky urine

Experiencing burning while urinating

Pyuria without a UTI can exhibit comparable signs. You might observe:

A bladder ache

Vomiting or nausea, which could be an indication of renal issues

Murky urine


Abdomen ache

Chills and a fever

Pyuria can occasionally occur without any symptoms. A yearly urine test is essential to identify any potential problems.

Risk elements

Women are more likely than men to experience pyuria. Older folks also experience pyuria more frequently. In older women, sterile pyuria is more prevalent. This corresponds to a normal decline in estrogen levels. Another condition that can raise the incidence of pyuria in women is menopause, which is associated with an increased risk of UTIs.

Your risk of developing pyuria may also rise if you engage in sexual activity. This is so because some STDs, like chlamydia, can result in pyuria. Your risk of UTI may also rise if you engage in sexual activity.


Your doctor can determine if you have pyuria with a urine sample known as a urinalysis. A lab technician will check for the presence of white blood cells, blood, and germs. White blood cells are present in every episode of pyuria; however, not every sample will contain bacteria or blood. Your doctor will be able to pinpoint the exact cause of pyuria using the quantity of these components.

Nitrites or leukocytes in the urine are indicators that a UTI is present. Your doctor will likely check for additional pyuria symptoms, such as elevated white blood cell counts if these components aren’t discovered during a urinalysis.


The etiology of pyuria affects how it is treated. Antibiotics are frequently used to treat UTIs. For up to two weeks, they are taken orally. Pyuria brought on by a fungus may be treated with antifungal drugs.

Antibiotic-resistant pyuria can have another underlying cause. To give one example, immunoglobulins are used to treat Kawasaki disease.

Stopping several prescription medications may help with persistent episodes of pyuria linked to pharmaceuticals. Your doctor might recommend a different type or brand in its stead.


Pyuria can cause other medical problems if left untreated. Since most cases are brought on by an infection of some kind, it is possible for this to spread throughout the body. Organ failure and blood toxicity can result from untreated illnesses. With untreated UTIs, permanent kidney damage is a worry. If untreated, severe pyuria cases could be lethal.

An erroneous diagnosis might occasionally make treatment more difficult. In rare instances, using an antibiotic to treat pyuria could make it worse. This may be so because many pyuria symptoms are actually caused by inflammation rather than a bacterial infection.

Pregnancy pyuria

A regular urinalysis may reveal pyuria if you are pregnant. Although this may be concerning, pyuria occurs frequently during pregnancy. It may occur as a result of excessive vaginal discharge. In order to suggest the best course of treatment if your test results show pyuria, your doctor will need to identify the underlying cause. While urinalysis results may be tainted by vaginal discharge, it’s crucial to rule out a UTI or other illness.

Pyuria in pregnant women typically doesn’t warrant worry. But if misdiagnosed or mistreated, it might put your health and the health of your unborn child in danger. A full-term baby born prematurely or with a low birth weight may be the result of severe pyuria brought on by an untreated UTI.


The underlying reason and the timing of treatment have a significant impact on the prognosis for pyuria. With prompt treatment, it can usually go away. You can experience recurrent episodes of pyuria if you frequently develop UTIs or have other persistent, chronic diseases.

The best course of action is to pay attention to your symptoms and get medical attention if anything doesn’t feel or look right. Additionally, it’s critical that elderly individuals, who may be more vulnerable to the beginning and subsequent problems of pyuria, receive quick medical attention. For a more precise diagnosis and course of treatment, your doctor could suggest that you see a urologist.

Frequently Asked Questions (FAQ’s)

Q. What is sterile pyuria?

A. Sterile pyuria is a condition where white blood cells are present in the urine, but there is no bacterial infection.

Q. What are the common causes of sterile pyuria?

A. Common causes include urinary tract infections that were treated with antibiotics, interstitial cystitis, kidney stones, and sexually transmitted infections (STIs) like chlamydia and gonorrhea.

Q. Is sterile pyuria dangerous?

A. Sterile pyuria itself is not dangerous, but it often indicates an underlying medical issue that should be evaluated and treated to prevent potential complications.

Q. How is sterile pyuria diagnosed and treated?

A. Diagnosis involves a urine test and medical evaluation to identify the underlying cause. Treatment depends on the underlying condition and may involve antibiotics, lifestyle changes, or other interventions as recommended by a healthcare professional.

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