Urine Leukocyte Esterase

Aka: Urine Leukocyte Esterase, Urine Dipstick Leukocyte Esterase

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II. Mechanism

  1. Neutrophil Granulocytes contain esterases
  2. Positive test suggests pyuria
    1. Dipstick requires 5 minutes to change color

III. Interpretation: Normal

  1. Negative

IV. Interpretation: Positive (Abnormal)

  1. Urinary Tract Infection
  2. Sexually Transmitted Infection
  3. Vaginal contaminant

V. Causes: False NegativeLeukocyte esterase on Urinalysis

  1. Inadequate time allowed for dipstick reading (60 to 120 seconds)
  2. Increased Urine Specific Gravity
  3. Urine Glucose present (Glycosuria)
  4. Urine Ketones present (Ketonuria)
  5. Urine Protein present (Proteinuria)
  6. Vitamin C
  7. Enterococcus UTI
  8. Klebsiella UTI
  9. Antibiotics
    1. Cefalexin (Keflex)
    2. Nitrofurantoin (Macrobid)
    3. Tetracycline
    4. Gentamicin

VI. Causes: Positive Leukocyte esterase and negative Urine Culture

  1. Chlamydia
  2. Ureaplasma urealyticum
  3. Balanitis
  4. Bladder Cancer
  5. Nephrolithiasis
  6. Tuberculosis
  7. Urinary tract foreign body
  8. Glomerulonephritis
  9. Medications (Corticosteroid, Cytoxan)
  10. Methenamine

VII. References

  1. Hitzeman (2022) Am Fam Physician 106(1): 27-35 [PubMed]
  2. Simerville (2005) Am Fam Physician 71(6): 1153-62 [PubMed]

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