What an Abnormal Leukocyte Esterase Result Means on a Urine Test

What an Abnormal Leukocyte Esterase Result Means on a Urine Test

When your urine test shows a leukocyte esterase abnormal reading, it indicates that white blood cells (leukocytes) or their enzymes are present in your urine. This finding can point to an underlying issue, most often an infection or inflammation in the urinary tract. Understanding what this result means—and what to do next—can help you and your doctor decide on the best course of action.

What Is Leukocyte Esterase?

Leukocyte esterase is an enzyme released by white blood cells when they break down pathogens. In a standard urine dipstick test, a color change occurs if the enzyme is present:

• Normal result: No color change (negative for leukocyte esterase).
• Abnormal result: Color change indicating trace, small, moderate, or large amounts of leukocyte esterase.

A leukocyte esterase abnormal result does not diagnose a specific disease but flags that your body may be fighting infection or inflammation.

Common Causes of a Leukocyte Esterase Abnormal Result

An abnormal leukocyte esterase reading often points to one of the following:

• Urinary Tract Infection (UTI)
  • Bacteria enter the urinary tract (bladder, urethra, sometimes kidneys).
  • White blood cells flock to the area to fight infection.
• Kidney Infection (Pyelonephritis)
  • A more serious UTI that travels from the bladder to the kidneys.
• Interstitial Cystitis or Bladder Inflammation
  • Chronic bladder irritation without bacterial infection.
• Sexually Transmitted Infections (STIs)
  • Gonorrhea or chlamydia can cause white blood cells to appear in the urine.
• Contamination of the Sample
  • Vaginal discharge or skin bacteria can introduce leukocytes if the sample isn’t collected cleanly.

Symptoms to Watch For

While a leukocyte esterase abnormal result alone isn’t a definitive diagnosis, these symptoms often accompany urinary tract issues:

• Frequent or urgent need to urinate
• Pain or burning sensation during urination
• Cloudy, dark, or strong-smelling urine
• Lower abdominal or back pain
• Fever or chills (suggesting kidney involvement)
• Unusual vaginal or penile discharge

If you’re experiencing any of these symptoms, consider a free, online symptom check, using the doctor approved Ubie Symptom Checker.

What Your Doctor May Do Next

An abnormal leukocyte esterase result typically prompts further evaluation:

1. Confirm the Finding
   • Repeat the urine dipstick test on a new, clean-catch sample.
   • Send the sample for a urine culture to identify specific bacteria.

2. Microscopic Examination
   • Check for white blood cells, red blood cells, and bacteria under the microscope.

3. Additional Testing
   • If infection is confirmed, tests for antibiotic sensitivity guide treatment.
   • Sexually transmitted infection panels if indicated by symptoms.
   • Imaging (ultrasound or CT) if kidney stones or structural issues are suspected.

Possible Treatments

Treatment depends on the underlying cause:

• Bacterial UTI or Kidney Infection
  • Oral antibiotics for bladder infections.
  • Intravenous antibiotics and hospitalization for severe kidney infections.
• Interstitial Cystitis
  • Bladder training, dietary changes, and medications to reduce pain or inflammation.
• STIs
  • Targeted antibiotic or antiviral therapy.
• Contamination
  • Repeat the urine test using proper collection methods.

Follow your doctor’s instructions fully, even if symptoms improve before finishing a prescribed antibiotic course.

When to Seek Immediate Medical Attention

While many causes of a leukocyte esterase abnormal result can be treated easily, some situations require prompt care:

• High fever (over 101°F or 38.3°C) with flank pain or vomiting
• Signs of sepsis: fast heartbeat, rapid breathing, confusion
• Blood in the urine (gross hematuria)
• Severe pelvic or abdominal pain

If you experience any of these symptoms, call your doctor or go to the nearest emergency department right away.

Preventing Urinary Tract Issues

You can lower your risk of UTIs and related problems with simple lifestyle steps:

• Drink plenty of water to flush bacteria from your system.
• Urinate when you feel the urge; don’t “hold it.”
• Wipe front to back after using the toilet (especially important for women).
• Urinate before and after sexual activity to clear bacteria.
• Wear breathable, cotton underwear and avoid tight-fitting pants.
• Consider probiotics or cranberry products (discuss with your doctor first).

Talking to Your Doctor

A leukocyte esterase abnormal result is a valuable clue but not a standalone diagnosis. It’s essential to discuss:

• Your symptoms and their duration.
• Any past history of UTIs, kidney stones, or bladder issues.
• Medications you’re taking, including over-the-counter supplements.
• Allergies to antibiotics or other treatments.

Be proactive in asking questions like, “What further tests do I need?” or “How quickly will I feel better on treatment?”

The Bottom Line

• A leukocyte esterase abnormal urine test suggests white blood cells are in your urine, often due to infection or inflammation.
• Additional tests—like urine cultures and microscopic exams—help pinpoint the exact cause.
• Treatments vary from simple antibiotics for UTIs to more specialized care for kidney infections or other conditions.
• Preventive steps can reduce your risk of future urinary tract problems.
• Always follow up with your healthcare provider for accurate diagnosis and tailored treatment.

Remember, if you have any life-threatening or serious symptoms, speak to a doctor immediately. And for more guidance on your symptoms, try a free, online symptom check, using the doctor approved Ubie Symptom Checker. Stay informed, stay proactive, and don’t hesitate to reach out for professional care when you need it.