What is the significance of urinalysis results showing leukocytes (white blood cells) of 117 and erythrocytes (red blood cells) of 1392, indicating leukocyturia and hematuria?

From the Guidelines

The urinalysis results showing 117 leukocytes and 1392 erythrocytes strongly suggest a urinary tract infection (UTI) with possible kidney involvement or urinary tract bleeding, and prompt medical attention is necessary to determine the underlying cause and appropriate treatment. The elevated leukocytes indicate an inflammatory response to infection, while the significantly elevated erythrocytes (red blood cells) suggest inflammation, infection, or possible kidney stones, trauma, or other urological conditions 1. According to the American Urological Association, hematuria is characterized as either microhematuria or gross hematuria, and the presence of 1392 erythrocytes indicates gross hematuria, which has a high association with malignancy of up to 30% to 40% 1.

Key Considerations

• The patient's symptoms, such as pain, burning during urination, fever, or visible blood in urine, should be evaluated promptly by a healthcare professional.
• The combination of both elevated leukocytes and erythrocytes is concerning and requires proper evaluation to determine the underlying cause and appropriate treatment.
• Treatment typically involves antibiotics, such as nitrofurantoin, trimethoprim-sulfamethoxazole, or ciprofloxacin, depending on local resistance patterns, and increasing fluid intake to help flush bacteria from the system 1.
• A thorough history, physical examination, urinalysis, and serologic testing should be performed prior to any initial imaging, and further evaluation, such as cystoscopy, may be necessary to determine the underlying cause of hematuria 1.

Next Steps

• Seek medical attention promptly to determine the underlying cause of the urinalysis results.
• Provide a thorough medical history, including any symptoms, to the healthcare professional.
• Follow the recommended treatment plan, including any prescribed antibiotics and increased fluid intake.
• Attend any scheduled follow-up appointments to monitor the condition and adjust the treatment plan as necessary.

From the Research

Urinalysis Results

The urinalysis results show leucocytes of 117 and erythrocytes of 1392.

Interpretation of Results

• The presence of leucocytes and erythrocytes in the urine can indicate a urinary tract infection (UTI) 2, 3.
• However, the interpretation of these results should be done in the context of the patient's symptoms and clinical presentation 2.
• A study found that urine flow cytometry can be used to measure bacterium and leucocyte counts in urine, and adapted cut-off values can be used to diagnose UTIs in different clinical presentations 4.
• The study found that a leucocyte count of >17/μL or a bacterial count of >125/μL can be used to diagnose UTIs, but the cut-off values may vary depending on the clinical presentation 4.
• Another study found that urine sediment microscopy is superior to automated urinalysis in terms of sensitivity and specificity for detecting UTIs, especially when examining red and white blood cells 5.

Clinical Implications

• The results of the urinalysis should be interpreted in the context of the patient's symptoms and clinical presentation to determine the likelihood of a UTI 2, 3.
• If the patient has symptoms of a UTI, such as dysuria, urgency, or frequency, and the urinalysis results show leucocytes and erythrocytes, it is likely that the patient has a UTI 2, 3.
• Further testing, such as urine culture, may be necessary to confirm the diagnosis and guide treatment 2, 3.