What to Do When a Urine Culture Shows Neg for UTI but AZO Strips Show Positive?

Updated on July 29, 2019
L.J. asks from Fort Worth, TX
16 answers

My daughter had a UTI July 5th, then was on antibiotics for 10 days. We went back on the 17th and urine showed trace amount of protein and small amount of leukocytes. Then on the 22nd she had fever and headache again, which is her only symptoms she’s had w/UTI. On the 23rd went back to doc and urine showed blood and all the other junk and they said it didn’t look good. But no leukocytes. So they started her on another antibiotic while they sent the culture off. Then today the doc calls and culture was negative for bacteria and said no uti and can stop antibiotic. When my daughter woke up later on this morning we used an AZO test strip and almost immediately it showed positive for leukocytes. I’m so confused! What do you guys think of this?

What can I do next?

  • Add yourAnswer own comment
  • Ask your own question Add Question
  • Join the Mamapedia community Mamapedia
  • as inappropriate
  • this with your friends

Featured Answers



answers from Miami on

If a doctor can't explain what is happening, what makes you think we can? If you're not satisfied with their response, the best thing to do is to get a second or even third opinion.

5 moms found this helpful

More Answers



answers from Pittsburgh on

White blood cells (leukocytes) are not bacteria. So, she could have a high WBC count in her urine without having an active infection. Nonetheless, something still isn't right so go back to the doctor and if you aren't getting anywhere with that doc, get a second opinion.

8 moms found this helpful


answers from Dallas on

Call the dr. Let them know your concerns. If you feel they are wrong take her for a second opinion.

7 moms found this helpful


answers from San Francisco on

I would call the doctor's office and ask. I'm not sure how accurate those otc tests are but your doctor's office will know for sure, so CALL.

7 moms found this helpful


answers from Springfield on

If you haven't already ...

I would just call the doctor's office and tell them what you told us. The nurse should be able to explain and answer any of your questions. If you are not confident in what the nurse tells you, you can always request to speak with the doctor.

I would be willing to bet the nurse will be able to answer your questions and reassure you.

6 moms found this helpful


answers from Washington DC on

Welcome to mamapedia, LJ

How old is your daughter?
is there a chance she could be pregnant?

Leukocytes are white blood cells that combat infections in the body but their presence in urine most often points towards a bacterial infection. Small amount of leukocytes are expelled through the urine which are usually the old and the damaged cells.

Here is some other information:

Maybe you should take your doctor to a urologist so she can be thoroughly evaluated? That's what I would do. I also would NEVER stop taking an antibiotic until the dosage is done. that's how one builds up an immunity to the antibiotic and it won't work in the future.

6 moms found this helpful


answers from Abilene on

My daughter battled UTI’s for the first 2 years of her life. Cultures can come back negative due to the patient being on antibiotics. In my daughter’s case, the colony of bacteria would be around 10,000 which they considered okay and as soon as she came off antibiotics and waited 10 days, it would soar back into the 80k-100k range. My daughter’s infections were due to her bladder not “tilting” yet (happens around age 2). She wound up on some form of antibiotic from 6 weeks to 2 years old. She had horrible stomach issues due to being on constant antibiotics no matter how much yogurt and probiotics I gave her. At about 2 years and 3 months everything was normal.

I think your doctor is wise to discontinue antibiotics if he feels they are unwarranted at this point. Checking with him or the pharmacist to see if she can stop abruptly or gradually is a good idea.

If she continues to have issues, you might consider a pediatric urologist visit. If you are concerned, speak to the pediatrician again but think of all of your questions and write them down. Maybe even ask if you could email your questions so they can address your concerns.

I’m sorry she’s having issues. Hang in there momma!

5 moms found this helpful


answers from Portland on

So it sounds like she might have some white blood cells but not significant enough to cause cause concern, and not enough bacteria to warrant still being on antibiotics - especially if there's no bacteria in her sample/culture.

I know with my kids and ear infections, they tended to not keep them on them if they didn't have to (once they used the whole dose) .. it was only if my kids got significantly worse rather than better.

Some trace amounts might be ok ... maybe that's just her body's way of fighting this infection off on her own. No idea.

I would just call and ask. I don't know enough about doing tests at home. I think this is the problem. You can do them yourself, but then you have questions and have to go in or at the very least, call anyhow.

Or you could call the 1-800 and ask the people who make the test or sometimes they have a FAQ page with questions just like this on their websites.

Good luck

5 moms found this helpful


answers from Washington DC on

i don't know, since i'm not a doctor, but i'm betting the home test strips are a very broad flag, not a focused diagnostic tool.

a UTI can be caused by a virus, so your doctor is wise to tell you to discontinue the antibiotic in the absence of bacteria. you don't want your daughter to take unnecessary antibiotics and develop resistence to them.

did the doctor actually say 'no UTI' or did you infer that from him saying the culture was negative for bacteria?

regardless, it sounds as if it's time to go to a pediatric urologist. there's only so much a general pediatrician is going to know about this.


4 moms found this helpful


answers from Denver on

From what I've read (and from what a friend who has frequent UTIs has told me), the home test strips should not be the standard by which you judge whether a UTI is present. They can be useful for telling a person that a doctor's visit is warranted, which you already did.

Since you have a negative culture, and apparently you have a doctor who seems proactive and does cultures and tests, I'd go by what your doctor says.

If your daughter has repeated and frequent UTIs, then I would suggest not relying on home test strips, but asking for a referral to a specialist. Otherwise, trust your doctor and stop the home testing.

Consult the pharmacist who dispensed the second antibiotic to make sure that stopping the antibiotic cold-turkey is ok, or how to taper off, or if it's best to continue the whole dose. The pharmacist can be your best most reliable source of that kind of info.

4 moms found this helpful


answers from Norfolk on

She might be on the edge of something.
Talk with the doctor and as long as you already have the antibiotics I would consider finishing them.
Have her drink plenty of water and cranberry juice.
If she uses bubble bath - that can be irritating - so have her take baths with 1 cup of plain yogurt in her water or have her take showers.

4 moms found this helpful


answers from Minneapolis on

Time to take her to a urologist since issues are ongoing. BTW, the home strips are not diagnostic, they simply screen for broad issues to help decide whether to see a doctor or not. The urine culture is diagnostic, so trust that. Now is the time to see a specialist since problems are not resolved with basic treatment.

3 moms found this helpful


answers from Washington DC on

Thanks for your question L J.

Just as a friendly reminder, per Mamapedia Guidelines:

Mamapedia does allow medical questions to be asked, however we do not encourage it. The first and best source for the answers to all such questions will always be an appropriate certified professional. Please always consult such a professional in these matters first and foremost.

Mamapedia does not offer medical advice to our members, and any such advice you receive on the site is taken at your own risk.


3 moms found this helpful


answers from Atlanta on

I would go to a Urologist and talk with them about the issues your daughter is having. You don't say how old she is, so it's rough to say what else to do.

2 moms found this helpful


answers from Albany on

If you have the urine tested while your child is ON antibiotics, the infection will not show up because it is on the road to being cured. You have to test the urine BEFORE you start antibiotics.
Your daughter cannot go around with an untreated UTI with fever and headache. It can go to the kidneys...and even to the blood. I don't want to scare you but once it goes to the blood, 50% of people die. So it is a serious issue.
I have had 32 back to back UTIs over the past 2 1/2 years and finally found a cure! I was visiting a urogynecologist (Dr Walter in Montreal) for a 3rd opinion and like the former 2, he suggested 6 months of antibiotics. I refused and was determined to find an alternative. He then handed me an ad for an over the counter product he said has shown promising results called Utiva, made with PACs from cranberries (but it is not d-mannose). I was sure it would not work but ordered it on line. I was shocked when a 33rd UTI did not develop. It is now about 3 months later and NO UTI. I am my old self. No more cloudy urine, pain on urination, aching kidneys, malaise, fever, wearing pads for leaks, constant worry about the UTI going to my kidneys etc.. And believe me, I did EVERYTHING including d-mannose, keeping super clean with 2 showers per day, drinking a lot of water, vaginal and oral probiotics, eating a lower carb diet, going on vaginal estrogen (which did work for 4 months until I had a cystoscopy)... This was all my daily protocol that kept the UTIs at a lower level while waiting for the identification of the bacterium in each of the UTIs. But it was the UTIVA that has been my salvation. The reviews are identical to mine. It sounds like your daughter is a child so you would need to consult with them as to suggestions as to dosage. Ask them to speak to your paediatrician. Good luck in any case!

1 mom found this helpful


answers from Los Angeles on

Sorry, i just trying.

For Updates and Special Promotions
Follow Us

Related Questions