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Urology/UTI negative culture red and white blood cells in urine culture

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Question
Two weeks ago I had symptoms of what I suspected was a UTI. I had burning with urination
needed to urinate more frequently , dull pain in lower abdomen and was generally feeling unwell.
Went to see a doctor in a local clinic and was told that dip test in office indicated UTI.  Was put on 3
day course of Bactrim and was told urine would be sent for a culture to insure proper antibiotic is being used.
I took the Bactrim and symptoms resolved in less then 3 days.  Now two weeks later I get a call from the doctor
saying the culture results came back and they are concerned because the culture was not positive for UTI but the sample did have some red and white blood cells.  Actually what the doctor said was that some bacteria did show up but it was of a mixed kind with some being gram positive which indicated UTI is very unlikely . They want me to come back for another UA because they are concerned about the blood in the urine in the presence of a negative culture. By the way the blood is microscopic and not visible.  I have to say that they have me pretty freaked out.  It has been two weeks , I have no symptoms and pretty much forgot about the whole thing and now I am worried because of their concern about the blood.  I am wondering if it possible that this was still  a UTI even though the culture did not indicate this.  Also how worried should I be about the red and white blood cells in the absence of a positive culture.  My gut feeling tells me that since my symptoms resolved with the antibiotic this was probably an infection but reading about  causes of blood in urine has me a bit freaked out...Also I am wondering if it is normal to
for culture results not to come back for two weeks? Seems like a long time to me..

Answer
Michelle:

Your symptoms and response to therapy strongly suggest a UTI regardless of what the culture showed.  The red blood cells in the urine specimen are probably from the infection, but a recheck of the urine to make sure everything has resolved is reasonable.  I can't imagine why it took 2 weeks to get a culture report back.  It usually takes 48-72 hours.

If there appears to be persistent blood in the urine, a checkup by a urologist might be reasonable.  If the new urinalysis is normal, forget about it.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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