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Pyuria

Medically Reviewed.Last updated on 05/07/2026.

Pyuria is when you have a lot of white blood cells or pus in your pee. UTIs are the most common cause, but STIs, viral infections and some medications can also cause it. The most common symptom is cloudy, strong-smelling pee. Treatment involves managing the cause.

What Is Pyuria?

Pyuria is a common condition in which you have high levels of white blood cells (leukocytes) or pus in your pee. Pus is a thick, discolored (white, yellow, pink or green) fluid that your body makes to help fight off an infection. You have pyuria (pronounced "pi-YER-ree-UH") if you have 10 or more white blood cells per cubic milliliter of pee. It may cause your pee to look cloudy or discolored.

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Pyuria may be a sign of many different health conditions, and treatment depends on its cause. It often appears alongside urinary tract infections (UTIs). UTIs are very common. Each year, healthcare providers treat 8 million to 10 million people for UTIs.

What is sterile pyuria?

Sterile pyuria is a type of pyuria in which you have white blood cells in your pee, but providers can’t detect any bacteria. It often appears due to a sexually transmitted infection (STI). It affects nearly 14 out of 100 women and about 2.5 out of 100 men.

Symptoms and Causes

Symptoms of pyuria

The most common symptoms include cloudy pee or pus in your pee.

If a UTI causes pyuria, your symptoms may include:

  • Pain in your side (flank), abdomen or pelvic area
  • Pressure in your lower pelvis
  • Peeing more than usual (frequent urination)
  • Sudden urges to pee (urinary urgency)
  • Leaking pee (urinary incontinence)
  • Pain while peeing (dysuria)
  • Blood in your pee (hematuria)
  • Pee that smells like ammonia
  • Fever
  • Nausea and vomiting

Pyuria causes

UTIs are the most common cause. Other causes may include:

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Certain medications may also cause pyuria, especially if you take them for a long time. These include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Antibiotics that have penicillin or sulfa
  • Water pills that help you pee more (diuretics)
  • Drugs that decrease how much acid your stomach makes (proton pump inhibitors)

Does pyuria indicate that I have a UTI?

Not always. UTIs are the most common cause of pyuria. But if you have pyuria, it doesn’t mean that a UTI is the cause. Your healthcare provider can diagnose the exact cause.

What is the difference between pyuria and a UTI?

Pyuria often develops because of another condition, usually a UTI. E. coli is the most common cause of UTIs.

Can you have pyuria without a UTI?

Yes. UTIs are the most common cause of pyuria. But there are other causes, including STIs, kidney stones and pneumonia.

Risk factors

You’re at a greater risk of getting pyuria if you:

  • Are female
  • Are over 45
  • Are sexually active

You’re also more likely to get it if you have menopause symptoms. The loss of estrogen during menopause can thin out vaginal tissues and cause dryness and irritation. This increases your risk of bacteria entering your urinary system and causing a UTI.

Diagnosis and Tests

How doctors diagnose pyuria

Your healthcare provider will review your health history, ask questions about your symptoms and conduct a physical exam. If they think you have pyuria, they’ll recommend a pee test (urinalysis). A lab technician will check your pee sample for:

  • White blood cells
  • Bacteria
  • Blood

Management and Treatment

How is pyuria treated?

Treatment depends on its cause. But it may include:

  • Antibiotics to treat a UTI or STI
  • Antifungal medicines to treat a fungal infection
  • Antiparasitic drugs to treat a parasitic infection
  • Immunoglobulins to treat Kawasaki disease
  • Stopping certain medications

What happens if it’s left untreated?

It depends on the cause. In severe cases, untreated pyuria may lead to serious conditions, like:

  • Blood poisoning (septicemia)
  • Kidney damage
  • Organ failure
  • Sepsis

Some of these conditions can be fatal.

When should I see my healthcare provider?

Call your healthcare provider as soon as you notice any changes in your pee or symptoms of a UTI or STI. These may include peeing problems or pain around your abdomen.

If your provider diagnoses you with a UTI or STI and your symptoms get worse, contact them again. You may need a different treatment, or you may have another condition.

You may want to ask questions during your appointment, including:

  • How did I get this issue?
  • What treatment do you recommend?
  • For how long and at what times of day should I take my medicine?
  • When should I start to feel better?
  • Do I need to schedule a follow-up appointment?
  • Should I see a urologist or nephrologist?

Outlook / Prognosis

What can I expect if I have pyuria?

With a proper diagnosis, the outlook is usually good. If you have a UTI, pyuria usually goes away a few days after starting antibiotics.

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Until you find out the exact cause of pyuria, it’s a good idea to avoid sexual intercourse. If you have an STI, you can pass the infection to your partner(s).

A note from Cleveland Clinic

It’s not always easy to talk about your bathroom habits. But if your pee looks cloudy or has a strong smell, that might be your body’s way of telling you that something is wrong and you should talk to a healthcare provider. They can diagnose pyuria with a pee test. Once they figure out the cause, they’ll work with you to get the best treatment.

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Medically Reviewed.Last updated on 05/07/2026.

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References

Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.

Care at Cleveland Clinic

If you have a condition that’s affecting your urinary system, you want expert advice. At Cleveland Clinic, we’ll work to create a treatment plan that’s right for you.

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