Finding pus cells in urine is a common observation in a urine routine test, but it often raises concern for patients when they see it mentioned in their urine test report. While a small number of pus cells can be normal, higher values may indicate infection or inflammation in the urinary tract.
This article explains what pus cells in urine mean, their normal range, related findings like epithelial cells in urine, leukocytes in urine, nitrite positive urine, and how to interpret a complete urine analysis correctly.
What Are Pus Cells?
Pus cells are essentially white blood cells (WBCs) that appear in urine when the body responds to infection or inflammation.
In medical terms, pus cells are also called leukocytes.
- Pus simply refers to thick fluid made of dead white blood cells and bacteria
- Pus in the urine is called pyuria
What Is Pus Cells in Urine?
Pus cells in urine indicate the presence of white blood cells detected during the microscopic examination of urine or urine microscopy.
They are usually reported as the number of cells seen per HPF (High Power Field).
HPF full form in medical: High Power Field
Normal Range of Pus Cells in Urine
| Category | Normal Pus Cells Range |
|---|---|
| Adults | 0–5 pus cells/HPF |
| Females | 0–6 pus cells/HPF |
| Pregnancy | Up to 6 pus cells/HPF |
- Normal pus cells in urine are usually occasional or minimal
- Pus cells normal range in female may be slightly higher due to contamination during urine collection
If your report shows:
- 6–8 pus cells in urine → Mild inflammation
- 8–10 pus cells in urine → Possible infection
- 15–20 or 25–30 pus cells/HPF → Strongly suggests urinary tract infection (UTI)
What Does High Pus Cells in Urine Mean?
High pus cells in urine may indicate:
- Urinary tract infection (UTI)
- Kidney infection
- Bladder infection
- Sexually transmitted infections
- Pregnancy-related urinary infection
- Poor hygiene or improper urine sample collection
In some cases, leukocytes in urine but no infection may occur due to dehydration or contamination.
Urine Routine and Microscopy Test Explained
A urine routine and microscopy test (also called urine R/M test, URM test, or RUA test) evaluates:
1. Physical Examination
- Urine appearance: Clear, slightly turbid, or turbid urine
- Turbid urine meaning: Cloudy urine often due to pus, bacteria, or crystals
- Concentrated urine indicates dehydration
2. Chemical Examination
- Urine pH level (normal urine pH: 4.5–8.0)
- Acidic urine means pH < 6.0
- Urine protein normal range: Negative to trace
- Urine sugar test: Normally negative
- Bilirubin in urine: Normally absent
- Urobilinogen in urine normal range: 0.2–1.0 mg/dL
- Leukocyte esterase positive: Suggests WBCs in urine
- Nitrite positive urine: Indicates bacterial infection
3. Microscopic Examination
- Pus cells
- Red blood cells in urine normal range: 0–2 RBCs/HPF
- Epithelial cells in urine normal range: 0–5 cells/HPF
- Casts in urine (hyaline casts, granular cast in urine, RBC casts)
- Yeast cells in urine
- Amorphous urates in urine or crystals
Epithelial Cells in Urine: What Do They Indicate?
Epithelial cells in urine line the urinary tract. A small number is normal.
| Finding | Interpretation |
|---|---|
| 1–2 epithelial cells/HPF | Normal |
| 4–6 epithelial cells in urine | Mild shedding |
| 8–10 or 15–20 epithelial cells/HPF | Possible infection or contamination |
- Squamous epithelial cells often indicate contamination
- High epithelial cells in urine may be seen in UTIs
- Epithelial cells in urine during pregnancy may be mildly increased
Other Important Urine Findings
- WBC in urine normal range: 0–5/HPF
- Bacteria in urine microscopy: Suggests infection
- Urine specific gravity normal range: 1.005–1.030
- Normal urine specific gravity reflects hydration status
- RBC cast in urine or red cell casts: Indicates kidney disease
- Hyaline casts in urine: Often normal
- Crystals in urine normal range: Occasional crystals are acceptable
Pus Cells in Urine During Pregnancy
Pus cells in urine during pregnancy should never be ignored. Even mild infections can affect both mother and baby. Regular urine routine examination is essential during antenatal visits.
How to Reduce Pus Cells in Urine
Medical Treatment
- Antibiotics (based on urine culture test results)
- Adequate hydration
- Treat underlying causes such as stones or diabetes
Home Care (Supportive)
- Drink sufficient water
- Maintain genital hygiene
- Avoid holding urine
- Repeat testing with urine re test if advised
How to Read a Urine Culture Report
- No growth: Normal
- Significant growth: Infection present
- Sensitivity test helps choose the right antibiotic
When Should You See a Doctor?
- Plenty of pus cells in urine
- Burning urination, fever, abdominal pain
- Recurrent UTIs
- Pus cells with blood in urine
- Pregnancy with abnormal urine report
FAQs
1. What is the normal range of pus cells in urine?
The normal range is 0–5 pus cells per HPF in adults.
2. What does leukocyte esterase positive mean?
It indicates the presence of white blood cells in urine, usually due to infection.
3. Can pus cells be present without infection?
Yes, mild pus cells may appear due to dehydration, contamination, or inflammation without infection.
4. What does turbid urine indicate?
Turbid urine often means the presence of pus cells, bacteria, crystals, or protein.
5. Is pus cells in urine dangerous during pregnancy?
Yes, it can be serious if untreated and should be evaluated promptly.
Disclaimer
This article is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis, interpretation of urine test reports, and treatment decisions.
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