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Leukocyte esterase (LE) is an esterase (a type of enzyme) produced by leukocytes (white blood cells). A leukocyte esterase test (LE test) is a urine test for the presence of white blood cells and other abnormalities associated with infection. White blood cells in the urine can indicate a urinary tract infection (UTI). Positive test results may ...
Neutrophil granulocytes are the leukocytes most commonly associated with urinary infections. A positive test for leukocyte esterase normally indicates the presence of bacteria and a positive nitrite test (although it is not always the case). Infections caused by Trichomonas, Chlamydia and yeasts produce leukocyturia without bacteriuria.
In the elderly, the leukocyte esterase test is often positive even in the absence of an infection. [citation needed] The urine dipstick test is readily available and provides fast, but often unreliable results. Some organisms such as chlamydia and Ureaplasma urealyticum will produce a negative leukocyte esterase reaction.
In straightforward cases, a diagnosis may be made and treatment given based on symptoms alone without further laboratory confirmation. [4] In complicated or questionable cases, it may be useful to confirm the diagnosis via urinalysis, looking for the presence of urinary nitrites, white blood cells (leukocytes), or leukocyte esterase. [54]
In the setting of UTI symptoms, positive dipstick results for nitrite and leukocyte esterase are strongly suggestive of a UTI, [138] [139] but negative results do not rule it out if there is a high degree of suspicion.
The principle of their operation is based on the detection of granulocytes esterases, including leukocytes. This method, however, is burdened with a large number of false positive results (use of antibiotics , such as imipenem , meropenem , clavulanic acid , which is sometimes combined with penicillin derivatives) or false negative ( gentamicin ...
Urinalysis is the most useful test to start the work up in a patient of dysuria. Urinalysis positive for nitrite carries a high predictive value of a positive urine culture. Also, urine dipstick showing leukocytes as equal predictive value as the presence of nitrites. When both are present, the predictive value goes even higher.
In men, urethritis is diagnosed by at least one of the following: mucopurulent or purulent urethral discharge on examination, ≥ 2 white blood cells per oil immersion field from a Gram stain of a urethral swab, or positive leukocyte esterase and/or ≥10 white blood cells per high power field of the first-void urine.