sterile pyuria

Last reviewed 07/2021

Sterile pyuria is the presence of elevated numbers of white cells (>10/cubic mm) in a urine which appears sterile using standard culture techniques.

The causes of sterile pyuria include:

  • a treated urinary tract infection (UTI) within 2 weeks of treatment/inadequately treated (UTI)
  • UTI with fastidious culture requirement
  • renal stones
  • prostatitis
  • chlamydia urethritis
  • renal papillary necrosis (e.g. from analgesic excess)
  • tubulo-interstitial nephritis
  • genitourinary tuberculosis (always consider - do 3 early morning urines)
  • interstitial cystitis
  • urinary tract neoplasm
  • polycystic kidney