Pus Cells in Urine: Normal Range, Causes, & Treatment

Pus cells refer to term given to the accumulation of dead white blood cells (WBCs) at the site of infection. When these pus cells are present in the human urine, the condition is known as Pyuria. It is normal for some pus cells to be paresent in the urine sample, however, an elevated number of pus cells in the urine sample are an indication of some underlying injection. In this article, let us discuss pus cells in detail including what pus cells are, why they are present in urine, what are the symptoms of presence of pus cells in urine, pus cell in urine normal range and whether or not it is normal to detect the presence of pus cells in urine.

Infections in your renal tract or even in the kidneys manifest in multiple ways. Early giveaways of the condition include painful urination, burning sensation while peeing or even itchiness and discomfort. If the symptoms don't go away easily, they could be indicative of something more severe that only proper testing can unfold. Get your blood checked as per your doctor's prescription.

What are Pus cells?

Pus cells are a collection of dead, white blood cells that accumulates when the body's immune system activates in response to an infection. These cells form a whitish-yellow or yellowish colored protein rich fluid at the site of the infection. This fluid is known as liquor puris. These pus cells may sometimes be present in your urine. This condition wherein the presence of white blood cells in urine is detected is known as pyuria. Pyuria can be sterile or non-sterile. Sterile pyuria refers to the presence of pus cells in urine without detection of any bacteria whereas, non sterile pyuria is due to the presence of bacterias.

Is the presence of pus cells in urine normal?

This is a question that often arises when individuals undergo routine urine tests or experience urinary tract symptoms. While a small number of pus cells can be considered normal, a significant increase in their presence may be a cause of concern.

It suggests the possibility of a urinary tract infection (UTI), kidney function, or other underlying conditions. Regular urine tests and prompt medical attention can help identify and address any urinary tract issues, ensuring optimal urinary health and overall well-being.

What is the normal range of pus cells in urine?

It is normal to have a small number of pus cells in the urine sample. The normal range of pus cells in urine when observed under a high power microscope varies slightly in males and females. The normal count of pus cells in male urine samples is around less than 4 cells / HPF, whereas, for females, the normal pus cells count in around 5 to 7 cells / HPF. The increased number of pus cells in urine can be observed physically through the visible changes in urine, that is, the urine may become thick and look cloudy like a pus. Therefore, if you observe changes in the texture or colour of urine, you should consult a doctor.

Why are Pus cells present in urine?

The presence of pus cells in the urine can be due to different reasons. Majorly the presence of pus cells in urine is due to an infection from bacteria or viruses. The main reasons that can lead to the occurrence of pus cells in urine include:

• Urinary tract infection (UTI), that is, infection in any part of your urinary system like urinary bladder, urethra, ureter or kidneys
• Sexually transmitted infection (STI) like viral infection or gonorrhea
• Interstitial cystitis
• Tuberculosis
• Bacteremia with sepsis
• Kidney disease
• Urinary tract stones
• Pneumonia
• Prostatitis
• Parasites
• Autoimmune diseases
• Polycystic kidney disease
• Tumour in the urinary tract
• Consumption of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen
• Penicillin antibiotics
• Diuretics
• Proton pump inhibitors like omeprazole

When should you get pus cells in a urine test done?

Pus cells in urine are an indication of urinary tract infection and in severe cases may indicate sepsis or any other health condition. Therefore, you should immediately get your urine test done if you observe one or more of the following symptoms:

• Excretion of a cloudy urine
• Change in texture or colour of the urine
• An increased frequency of urination
• Presence of blood in urine
• A burning sensation while urinating
• Pain in the pelvic region
• Passing of urine that has a foul smell
• Fever 
• Pain in the abdominal region
• Shortness of breath
• Abnormal discharge from the vagina
• Vomiting or nausea

What causes Pus in urine?

Pus in urine, or pyuria, is caused by white blood cells (WBCs) in the urine; it suggests infection in the urinary tract or other related systems. Here are the primary causes of pus in urine:

Urinary Tract Infections (UTIs)

• Bacterial Infections- The most common cause of pyuria is a bacterial infection, which can affect the urethra, bladder, ureters, and kidneys. Common bacteria like Escherichia coli (E. coli) can cause these infections.
• Cystitis- Inflammation of the bladder, often due to a bacterial infection, can lead to pus in the urine.
• Urethritis- Infection or inflammation of the urethra can also cause pyuria.

 Kidney Infections (Pyelonephritis)

• Ascending Infections: A severe urinary tract infection can spread from the bladder to the kidneys, leading to pyelonephritis, often resulting in pus in the urine.

Sexually Transmitted Infections (STIs)

• Chlamydia and Gonorrhea: These STIs can cause inflammation of the urethra (urethritis), leading to pus in the urine. Women may also experience pelvic inflammatory disease (PID), which can result in pyuria.

Interstitial Cystitis

• Chronic Bladder Condition: Interstitial cystitis, a chronic condition that causes bladder pain and frequent urination, can sometimes cause white blood cells to be present in the urine, resulting in pyuria.
• Kidney Stones (Nephrolithiasis) Obstruction and Infection: Kidney stones can cause blockages in the urinary tract, leading to irritation, infection, and pus in the urine.

Tuberculosis

• Renal Tuberculosis: Tuberculosis can spread to the kidneys, causing a form of pyelonephritis known as renal tuberculosis, which can lead to pus in the urine.

Prostatitis

• Inflammation of the Prostate: In men, inflammation or infection of the prostate gland (prostatitis) can lead to pyuria.

Bladder or Kidney Infections (Abscesses)

• Localized Infections: Abscesses in the bladder or kidneys can lead to pus formation, which may then be excreted in the urine.

Vaginal Infections

• Contamination: In women, vaginal infections like bacterial vaginosis or yeast infections can sometimes cause contamination of urine samples, leading to the appearance of pus in urine.

Who is affected by Pyuria?

Pyuria can affect many people; here's a closer look at who is most commonly affected-

• People with UTIs Urinary Tract Infections
• Older adults with chronic conditions of UTIs
• Pregnant Women
• People with Catheters
• People with Diabetes
• Patients with Kidney Stones
• People with STIs (Sexually Transmitted Infections)
• Immunocompromised People
• Children
• People who take certain medications

Where does pus form?

Pus can form in various parts of the body where infections occur. Here are some common locations:

• Skin- Acne, boils, abscesses, and infected wounds can all produce pus.
• Internal organs- Infections in organs like the lungs, liver, kidneys, or brain can lead to the formation of pus-filled abscesses.
• Teeth and gums- Dental infections can cause pus-filled abscesses.
• Joints- Infections in joints can also produce pus.

Essentially, whenever your body is fighting off an infection, especially one caused by bacteria, pus can form as a byproduct of the immune response.

Symptoms of Pus in Urine

Here are some common Symptoms of Pus in urine-

• Cloudy or Murky Urine
• Foul-Smelling Urine
• Painful Urination (Dysuria)
• Burning Sensation
• Frequent Urination
• Urgency
• Pain in Lower abdomen Pelvic Pain
• fever and Chills
• Back or Flank Pain
• Kidney Involvement
• Nausea and Vomiting
• Blood in Urine (Hematuria)
• Urgency with Incomplete Emptying

Pus indicates infection, and its presence, symptoms, and odour suggest that your body is trying to fight off bacteria or other pathogens. It's important to seek medical attention to treat the underlying cause and prevent further complications.

Can pus in urine be prevented?

Yes, pus in urine (pyuria) can often be prevented by decreasing the risk of urinary tract infections (UTIs) and other conditions that lead to inflammation in the urinary tract. Here are some tips to avoid pus in urine-

Maintain Good Hygiene

Don't forget to wipe from front to back after using the toilet to prevent bacteria from the anal area from spreading to the urethra. Additionally, wash your genital area while bathing and after intercourse to reduce your risk of infection.

Stay Hydrated

• Stay hydrated to flush bacteria out of the urinary tract, reducing the risk of infection.
• Don't hold in urine for long periods; frequent urination aids to remove bacteria from the urinary tract.

Practice Safe Sexual Activity

• Urinating after sexual activity can help flush out bacteria that may have entered the urethra.
• Condoms can lower your risk of sexually transmitted infections (STIs) that could lead to pyuria.

Proper Use of Catheters

• Ensure catheters are inserted under sterile conditions to prevent infection.
• If long-term catheter use is necessary, maintain regular and proper cleaning to minimize the risk of infection.

Avoid Irritants

• To avoid urinary tract irritation, use unscented soaps, feminine hygiene products, and laundry detergents.

Manage Chronic Conditions

• Manage diabetes, as it can increase your risk of urinary infections.

Prompt Treatment of Infections

• If you develop symptoms of a UTI or another infection, seek prompt medical treatment to prevent the infection from worsening and leading to pyuria.

Preventing pus in urine involves a combination of good hygiene practices, healthy lifestyle choices, and prompt treatment of any infections. If you are inclined to have recurrent infections or underlying health issues, consult your doctors to prevent pus in the urine.

Treatment and Management

When it comes to the presence of pus cells in the urine, early diagnosis, timely treatment, and effective management are essential for maintaining urinary health.

1. Antibiotics for bacterial infections

If the urine test reveals a bacterial infection, antibiotics are commonly prescribed. These medications target and eliminate the bacteria causing the infection, restoring normal urinary function.

2. Antifungal medications for fungal infections

In cases where the presence of pus cells is due to fungal infections, antifungal medications are typically recommended. These medications target the fungus responsible for the infection and help restore and help restore a healthy urinary tract.

3. Lifestyle and preventive measures

Apart from medical interventions, adopting certain lifestyle habits and preventive measures can contribute to the management and prevention of pus cells in urine. Here are a few important practices to consider:

• Staying well-hydrated
• Maintaining good personal hygiene
• Avoiding irritants (such as harsh soaps, douches, and scented products in the genital area)
• Avoiding potential allergens

It is essential to consult a healthcare professional for proper diagnosis, guidance, and personalized recommendations to ensure optimal urinary health.

How to Diagnose Pyuria?

When pus cells are detected in urine, undergoing diagnostic procedures is crucial to determine the underlying cause and appropriate treatment. 

1. Pus cells urine test / Urine Analysis

A urine analysis is typically the first step in diagnosing the presence of pus cells. It involves examining a urine sample under a microscope to quantify the number of pus cells present.

2. Urine Culture

In cases where the presence of pus cells suggests a bacterial infection, a urine culture may be ordered. This test involves cultivating the bacteria present in the urine sample to identify the specific type of bacteria causing the infection.

3. Additional Tests for Identifying Underlying Causes

In some instances, the presence of pus cells in urine may be indicative of an underlying condition other than a simple urinary tract infection. To identify these underlying causes, additional tests may be conducted. These include - ultrasound, complete blood count test, kidney function test, etc.

Takeaway

The presence of pus cells in urine is an important indicator of urinary tract infection (UTI) and this indicator should not be overlooked. You must get a urine test as soon as you experience a burning sensation or increased frequency of urination. Now, that you are aware of the normal range of pus cells in urine, the reasons due to which the pus cells may be present in the urine and the symptoms when you should get a urine test done, you will be better able to analyse your health condition and take the right decision at the right time.

Frequently Asked Questions (FAQs)

1. How to reduce pus cells in urine?

There are certain natural ways by which you can reduce the number of pus cells in urine. These include:

• Keep yourself hydrated
• Cranberry juice and green tea extract can also help in reducing the number of pus cells
• Applying a wet warm compress to the area
• Painkillers like aspirin

2. What do pus cells in urine indicate?

The presence of pus cells in urine are in general an indication of urinary tract infection (UTI) and in severe cases, it can be due to sepsis.

3. How to test for Pyuria?

The most accurate test for pyuria is by counting the number of leukocytes in fresh urine samples. You can easily get your test done at Redcliffe labs.

4. Are Pus Cells in urine a warning sign of an Infection?

Generally, pus cells in urine are not a cause for alarm. However, it is always good to have them checked by a doctor to rule out an infection. If it does turn out to be an infection, it can be treated accordingly. While the main component of pus is the dead white blood cells, it also contains other debris. This may include dead neutrophils, which can indicate a bacterial infection near the site of the infection. The body's immune system will then attack these bacteria. These cells will be cleared away by macrophage cells, which are a type of immune cell devoted to eating bacteria. The presence of pus cells in urine can be a warning sign of an infection, particularly urinary tract infections. The condition is not usually serious, but it can cause pain and fever. The urine sample can be analyzed under a microscope to see if there is a significant number of pus cells present. If more than four pus cells are visible under a high-field microscope, then there is a higher chance of an infection. This is considered pyuria.