Sterile pyuria is seen in?
(Ref. Harrison's Internal Medicine 18th Chapter 283.)
a. Counts of 10,000 or less/ml are due to contamination during voiding and are of no significance.
b. In most instances, growth of >105 organisms per milliliter from a properly collected midstream "clean-
c. Catch" urine sample indicates infection – significant bacteriuria.
d. When carefully sought by chamber-count microscopy, pyuria is a highly sensitive indicator of UTI inSymptomatic patients.
e. Pyuria is demonstrated in nearly all acute bacterial UTIs, and its absence calls the diagnosis into question.
f. The leukocyte esterase "dipstick" method is less sensitive than microscopy in identifying pyuria but is a Useful alternative when microscopy is not feasible.
g. Pyuria in the absence of bacteriuria (sterile pyuria) may indicate infection with unusual agents such as C. Trachomatis, U. urealyticum, or Mycobacterium tuberculosis or with fungi.
h. Alternatively, sterile pyuria may be documented in noninfectious urologic conditions such as calculi, Anatomic abnormality, nephrocalcinosis, vesicoureteral reflux, interstitial nephritis, or polycystic disease.