Bacteriuria, Urinary Tract Infection

What is pyuria?

Pyuria is the presence of pus (leukocytes or white blood cells) in the urine. It is a laboratory finding in many diseases, most commonly infection in the urinary system.

How is it diagnosed?

History Pyuria has no symptoms. The symptoms that are reported by an individual are the clues to the underlying disease. The individual may seek medical attention because of cloudy and foul smelling urine.

Individuals with infection of the lower urinary tract may report symptoms of frequent urination (frequency), painful urination (dysuria), and pain or discomfort in the lower abdomen.

Kidney infections (pyelonephritis) are accompanied by fever, chills, nausea and vomiting, and abdominal, back and loin pain.

Infections of the prostate gland (bacterial prostatitis) can cause fever and chills, groin pain, dysuria, frequency, and difficulty in urination.

Physical exam: Physical findings will vary depending on the disease responsible for the pyuria. Fever could indicate infections. High blood pressure (hypertension) can indicate various diseases that affect the kidneys and produce pyuria. Longstanding diabetes that affects the kidneys (papillary necrosis) has physical findings unique to the disease. The urine itself may be cloudy and odorous, but some pyuria is only detectable with a microscope.

Tests: Pyuria is confirmed via microscopic urine examination (urinalysis) and chemical analysis of the urine. Urine test sticks are a good screening procedure. There are many other laboratory lab tests and procedures that are used to diagnose the diseases responsible for the pyuria.

How is pyuria treated?

Treatment depends on the underlying disease.


Information Brand Generic Label Rating
Levofloxacin Levaquin Levofloxacin On-Label Cipro Ciprofloxacin On-Label
Minocin Minocin Minocycline Off-Label
Principen Principen Ampicillin On-Label Augmentin Amoxicillin/Clavulanate On-Label
Ilosone Erythromycin On-Label
Adoxa Doxycycline On-Label
Noroxin Norfloxacin On-Label

What might complicate it?

In females, efforts should be made to ensure that the urine specimen is not contaminated with vaginal secretions. Careful collection of urine specimens and the timing of the collection are important because once infections are eliminated from the possible diagnoses, other causes of the pyuria can be investigated.

Predicted outcome

Outcome depends on the underlying cause.


Cloudy urine can also be a result of precipitated salts in less acidic (alkaline) urine. Diet and drugs can be the cause of foul smelling urine.

Appropriate specialists

Urologist, internist, and nephrologist.

Last updated 18 December 2015


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