From the Guidelines
It is possible to have a kidney infection without leukocytes in the urine, as indicated by the European Association of Urology guidelines, which state that pyelonephritis can present with or without symptoms of cystitis, including leukocytes 1. When diagnosing kidney infections, urinalysis is recommended, including assessment of white and red blood cells and nitrite 1. However, the absence of leukocytes does not rule out a kidney infection, as other indicators such as bacteria in urine, flank pain, fever, nausea, and vomiting can still be present. Some key points to consider in the diagnosis and treatment of kidney infections include:
- Prompt differentiation between uncomplicated and potentially obstructive pyelonephritis is crucial, as the latter can swiftly progress to urosepsis 1.
- Fluoroquinolones and cephalosporins are recommended for oral empiric treatment of uncomplicated pyelonephritis 1.
- Patients with uncomplicated pyelonephritis requiring hospitalisation should be treated initially with an intravenous antimicrobial regimen 1. If kidney infection is suspected despite negative leukocyte results, additional testing such as urine culture, blood tests, or imaging studies may be necessary for diagnosis, as recommended by the European Association of Urology guidelines 1.
From the Research
Kidney Infection Without Leukocytes
- The provided studies do not directly address the question of having a kidney infection without leukocytes 2, 3, 4, 5.
- However, it can be inferred that the presence of leukocytes is often used as an indicator of infection, including kidney infections 2, 3.
- The studies focus on the diagnosis, treatment, and prevention of urinary tract infections, including pyelonephritis, which is a type of kidney infection 2, 3, 4, 5.
- They discuss the use of antibiotics, imaging, and other diagnostic tools to manage kidney infections, but do not specifically address the absence of leukocytes in these infections 2, 3, 4, 5.
Diagnosis and Treatment
- Urine culture is recommended for the diagnosis and management of pyelonephritis, recurrent urinary tract infection, and complicated urinary tract infections 3.
- Antibiotics targeted toward Escherichia coli, Proteus, Klebsiella, and Staphylococcus saprophyticus are the recommended treatment 3.
- The duration of treatment varies by specific drug and type of infection, ranging from 3 to 5 days for uncomplicated cystitis to 7 to 14 days for pyelonephritis 3.
Antibiotic Therapy
- Short-course antibiotic treatment is at least as effective as longer courses for both microbiological and clinical success in the treatment of acute uncomplicated pyelonephritis 4.
- Oral antibiotics, including amoxicillin, amoxicillin-clavulanic acid, and cephalexin, have potential to be effective for a proportion of patients with pyelonephritis 5.
- Ciprofloxacin may be effective at lower doses than currently prescribed 5.