Sterile pyuria

Background

• Persistent white cells in urine with negative bacterial culture
• Present in 14% of women and 3% of men

Differential Diagnosis

• Infectious causes
  • Sexual transmitted infection, including gonorrhea and chlamydia, but also genital herpes, herpes zoster, HPV and advanced HIV
  • Genitourinary tuberculosis
  • Candida, but also potentially aspergillosis, cryptococcosis, and endemic fungi
  • Trichomonas vaginalis
  • Schistosoma
• Non-infectious causes
  • Interstitial cystitis
  • Painful bladder syndrome
  • Kawasaki disease
  • Systemic lupus erythematosus
  • Analgesic nephropathy
  • Urinary stone
  • Foreign body
  • Bladder tumour