Lab results - looking for opinions [PLEASE READ 1ST POST]

Ronald Martin, thanks a ton

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Greetings!

I was hoping someone might be able to walk me through a bit of medical logic here—specifically regarding whether a standard urine culture report can actually confirm the presence of inflammation or any specific bacterial activity.
Now, I am fully aware that there is a massive spectrum of potential pathogens that can trigger an infection—it's not exactly a one-size-fits-all situation—but what I’m trying to get at is this: can a simple urine culture alone tell you that bacteria (and thus, inflammation) are present, leaving the more targeted, granular testing for later once the culprit is identified?

To put it in more practical terms—say, if someone happens to have a bacterium that triggers urethritis—is it possible for a urine culture to come back completely "normal" or clear despite the underlying issue being there?

Much appreciated.

Tyler Lewis3 said:Hey there!

I was wondering if someone could walk me through whether a urine culture alone can actually confirm the presence of inflammation or specific bacteria.
I’m fully aware that there’s a massive variety of different pathogens that cause infections, but what I’m trying to figure out is if the culture itself identifies that *some* kind of bacteria is present, which then acts as the trigger to run more targeted tests to pinpoint the exact culprit.

To put it specifically: if you happen to have a bacterium causing inflammation in the urethra, is it possible for a urine culture to come back completely normal?

Thanks,

Hi,

A urine culture is essentially a microbiological test designed specifically to hunt down pathogenic bacteria in your urine. So, if the culture comes back negative, it means there wasn't a high enough concentration of pathogens detected. That said, it’s definitely possible to get a false negative. This usually happens if there's less than a four-hour window between your last trip to the bathroom and when the sample was collected, or if you happened to take any over-the-counter anti-inflammatories or even just a heavy dose of Vitamin C the day before. Even things like cranberry juice or certain herbal supplements can throw the results off.

Sample Collection Time: 10/09/2018 07:11 AM

LABORATORY BIOCHEMICAL TEST RESULTS
- REPORT SUMMARY -
ERYTHROCYTE SEDIMENTATION RATE
Test Type | Result | Reference Range | Unit
(CK) ESR (hours) | 7 | 0-10 mm
HEMATOLOGY PANEL
Test Type | Result | Reference Range | Unit
(K) WBC | 4.4 | 3.4-9.7 x10*9/L
(K) RBC | 4.51 | 4.34-5.72 X10^12
(K) Hemoglobin | 12.4* | 13.8-17.5 g/dL
(K) Hematocrit | 0.39* | 0.41-0.53
(K) MCV | 85.2 | 83.0-97.2 fL
(K) MCH | 27.5 | 27.4-33.9 pg
(K) MCHC | 32.2 | 32.0-34.5 g/dL
(K) Platelets | 238 | 158-424 x10*9/L
(K) RDW | 13.2 | 9.0-15.0 %
(K) MPV | 8.6 | 6.8-10.4 fL
White Blood Cell Differential
Test Type | Result | Reference Range | Unit
(K) Neutrophils | 47.2 | 44-72 %
(K) Lymphocytes | 35.3 | 20-46 %
(K) Monocytes | 7.5 | 0-12 %
(K) Eosinophils | 7.10* | 0-7 %
(K) Basophils | 0.8 | 0-2 %
Coagulation Profile
Test Type | Result | Reference Range | Unit
(KK) Fibrinogen | 6.1* | 3.0-5.0 g/L
URINALYSIS
Test Type | Result | Reference Range | Unit
(U) Appearance | Clear | descriptive
(U) Color | Yellow | descriptive
(U) pH | 4.8-7.5 | pH units
(U) Specific Gravity | 1.003-1.040 | 1
(U) Protein | Negative | negative g/L
(U) Glucose | Negative | negative mmol/L
(U) Ketones | Negative | negative mmol/L
(U) Bilirubin | Negative | negative umol/L
(U) Urobilinogen | 1-16 | 1-16 umol/L
Microscopic Urine Sediment Examination
Test Type | Result | Reference Range | Unit
(U) RBCs | Occasional* | 0-2 per HPF
(U) WBCs | 2-3* | 0-5 per HPF
(U) Epithelial Cells | Occasional | per HPF
(U) Casts | None | per HPF
(U) Bacteria | Few | per HPF
(U) Precipitated Salts | Present | per HPF
(U) Crystals | Present | per HPF
(U) Fungi | None | per HPF
(U) Mucus | Few | per HPF
(U) Parasites | None | per HPF
(U) Other | Negative | per HPF
CLINICAL BIOCHEMISTRY
Test Type | Result | Reference Range | Unit
(S) Serum Glucose | 5.50 | 3.9-6.2 mmol/L
(S) Urea | 5.1 | 2.5-7.5 mmol/L
(S) Creatinine | 95 | 65-120 umol/L
(S) Uric Acid | 247 | 208-428 umol/L
(S) Total Cholesterol | 6.52* | L
(S) HDL Cholesterol | 2.10* | 1-2 mmol/L
(S) LDL Cholesterol | 3.92* | L
(S) Triglycerides | 1.10 | 0.4-1.9 mmol/L
(S) Iron | 11.20 | 11.0-32.0 umol/L
(S) TIBC | 49.00-72.00 | umol/L
(S) UIBC | 25.00-59.00 | umol/L
(S) Total Bilirubin | 22.1* | 5.0-21.0 umol/L
(S) AST: Aspartate Aminotransferase | 15 | 0-38 U/L
(S) ALT: Alanine Aminotransferase | 26 | 0-48 U/L
(S) GGT: Gamma-Glutamyl Transferase | 57* | 0-55 U/L
(S) Alkaline Phosphatase | 54 | 30-142 U/L
(S) Serum Amylase | 34 | 22-100 U/L
(S) Total Protein | 70.6 | 62.0-80.0 g/L
(S) Albumin | 40.5 | 35.0-52.0 g/L
(S) Albumin/Globulin Ratio | 1.3 | 1.1-1.7
(S) Calcium | 2.26 | 2.14-2.75 mmol/L
(S) Sodium | 141 | 136-146 mmol/L
(S) Potassium | 5.3* | 3.9-5.1 mmol/L
(S) Chloride | 104 | 97-108 mmol/L
(S) LDH: Lactate Dehydrogenase | 174 | 0-247 U/L
(S) Globulins | 30.1 | 27.0-35.0 g/L
(S) TIBC | 51.5 | 49.00-72.00 umol/L
(S) UIBC | 40.27 | 25.00-59.00 umol/L

CK - Citrate blood; K - EDTA blood; KK - Capillary blood; S - Serum; U - Urine;

Male, age 50+

Reason for testing - routine checkup during marathon training.

I would appreciate any insight or thoughts on this, thank you!

@ Peter Ross21

To me looks pretty clean overall, though your iron and hemoglobin levels are running a bit low, and your cholesterol is creeping up just a touch. Nothing to lose sleep over, honestly.

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Could someone please help me out here. My 9-month-old has a high leukocyte count in their urine, and the culture came back showing a mixed culture at 10,000 cfu/ml. Is this considered normal, or should we be looking into treatment?

Emily Ortiz27 said:To anyone out there who might be willing to lend a hand, I'm typing out two different biopsy results from the exact same lymph node, taken about five months apart.
We had these done because my kid's lymph nodes have been swelling up for almost a year now—mostly in the neck area, with one hitting 3.5 cm and a few others around 2 cm. All the serology came back negative for everything, and we even tried a five-day trial course of Sumamed.

First biopsy: Highly cellular aspirate—shows a majority of lymphatic cells in various stages of transformation, macrophages, lymphoglandular bodies, and peripheral blood.
Second biopsy: Dense mass of lymphatic cells, predominantly small lymphocytes, some lymphocytes, some immunoblasts, plasmacytoid cells, an occasional mitosis, numerous naked lymphatic cell nuclei, stretched nuclear material, and lymphoglandular bodies.

Would anyone be so kind as to explain what these terms actually mean? Is this what a healthy node is supposed to look like?
Thanks so much!

Could a low IgA ( The rest of the blood work—CBC via counter and microscopy, markers, proteins, and enzymes—all look normal, though the lymphocyte percentage is slightly elevated at 55.1 (ref range 15-55) and IgG is sitting at 14.81 (ref range 6.4-14.2)

Thanks

Hey there,
I was wondering if anyone here could help me make sense of my wife's radiology report following her surgery. She’s been scheduled for a biopsy...

Kenneth Allen11, what exactly is it you're looking for here? From what I can gather, the way this is being described sounds pretty benign. It’s basically just standard stuff—once the surgery is over, the body naturally absorbs those smaller amounts on its own. But as for that one specific case they found, they're going to have to perform a biopsy just to figure out exactly what they're dealing with.

Hey everyone,
I was wondering if I could get some insight regarding high red blood cell counts.
More than six months ago, my levels were slightly elevated at 5.79, but I just got my latest results back and they’ve jumped up to 6.12. I haven't been spending any time hiking in high altitudes or anything like that lately, so that shouldn't be a factor.
My doctors are telling me everything looks fine, though if I'm being honest with myself, I really don't drink nearly enough water—I'm wondering if staying chronically dehydrated could be enough to keep these numbers consistently high. Everything else on the panel came back perfectly normal.
I'm 32 years old, and I can't recall them ever being above 5 when I was younger.
Thanks so much for any help you can give.
Best,

Ronald Martin said:Rock, what exactly are you worried about here? Based on how this looks, it’s pretty benign; basically, after surgery, it's normal to see some discharge, and most of it just resorbs on its own, but for that one specific spot they flagged, they're going to have to do a biopsy to figure out exactly what's going on.

Thanks for getting back to me so fast!
We aren't doctors, so we don't really speak the jargon, which is why we're trying to figure out if this report is generally okay... we just want to make sure things aren't heading toward a complication, though I'm not even sure if that's something you can tell just from looking at these results.
And I guess that biopsy will give us the real answer...

casualpuma said:Hey everyone,
I’m looking for some perspective on high red blood cell counts.
More than six months ago, they were slightly elevated at 5.79, but I just got my latest labs back and the count hit 6.12. I haven't been spending any time up in the Rockies or living at a high altitude lately.
My doctors seem to think everything is fine, though the only thing I can point to is that I don't really drink much water throughout the day—I'm not sure if that's enough to cause a persistent elevation like this. Everything else looks normal.
I'm 32, and if I recall correctly, they never used to climb above 5 when I was younger.
Thanks for the help.
Best,

Look, if all your other markers look good—specifically your hematocrit, which is basically the ratio of red blood cells to the rest of your blood volume—then besides altitude, you might just be chronically dehydrated or perhaps you're a smoker...

About two years back, I had this testing done because of bone pain and concerns about rheumatoid arthritis or something similar...

HLA-A
2 10

HLA-B
15 ND

method: CDC(serological)

__________________________

HLA-C*
NT NT

HLA-DRB1*
04 11

HLA-DQB1*
NT NT

Method: PCR-SSO/SSP (molecular)

My GP told me everything looked fine
so I didn't bother following up with a rheumatologist
The pain hasn't gone away, but I've just been ignoring it
Now, though, I'm starting to suspect celiac disease—or maybe some other inflammatory bowel issue—given some other symptoms I'm having
Does anyone know if there's anything in these results that could point toward celiac, Crohn's, or anything like that?
I honestly have no idea how to read this report
Thanks!

Chris Kim63 said:About two years ago, I had this testing done because of bone pain and suspected rheumatoid arthritis...

HLA-A
2 10

HLA-B
15 ND

method: CDC (serological)

__________________________

HLA-C*
NT NT

Spondyloarthritis HLA-DRB1*
04 11

HLA-DQB1*
NT NT

Method: PCR-SSO/SSP (molecular)

My primary care physician told me everything was fine,
so I didn't follow up with a rheumatologist.
The pain persists, but I ignore it.
Now, given other symptoms, I suspect celiac disease (or perhaps some other inflammatory bowel disease).
Can anyone tell me if these results indicate anything regarding celiac, Crohn's, or similar conditions?
I don't understand this report at all.
Thanks!

This is genetic typing, which indicates predisposition to certain diseases. You can have one, two, or none.
HLA A2—predisposition to spontaneous miscarriage.
HLA-A10-Oralan—oral fibrosis.
HLA-B15-possible for Spondyloarthritis.
HLA-DRB1 4—linked to rheumatoid arthritis and lupus.
HLA-DRB1 11—systemic scleroderma.

If I were you, I would see a rheumatologist. It is better not to comment on the GP's assessment.
I went through the same thing; I didn't understand any of it initially either. 🤣

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Maria Kern71 said:It’s just genetic typing. It shows predispositions, nothing more. You might have one marker, two, or none at all.
HLA A2—linked to recurrent miscarriages
HLA-A10-Oralan—oral fibrosis
HLA-B15-possible for Spondyloarthritis HLA-DRB1
HLA-DRB1 4—associated with rheumatoid arthritis and lupus
HLA-DRB1 11—systemic scleroderma

If I were you, I'd go see a rheumatologist. Better to let a doctor handle the commentary.
I went through the same thing; I didn't understand any of this at first either.🤣

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Thank you so much! You have no idea how much this helps. I've been searching the internet for explanations like this for ages and found nothing.
Thanks, really. 🙏
Yeah. Not sure why I haven't switched doctors after all these years, but it's definitely time to say goodbye.

Chris Kim63 said:Thanks so much! You have no idea how helpful you've been. I've been searching online for these explanations for ages without any luck.
Thank you. 🙏
I suppose I don't know why I haven't switched doctors over the years, but it is certainly time to move on.

Glad I could be of some assistance. 🙂 It requires significant research to understand this stuff; I had quite a headache just trying to figure it out myself. 🤣 I am not sure where you are located, but if you are in the USA, I can send you a private message with a recommendation. 🙂

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Maria Kern71 said:Glad I could help even just a little bit. 🙂 Honestly, you have to dig through so much stuff and study it constantly; my head was spinning just trying to find answers for myself. 🤣 Not sure where you're based, but if you're in the USA, I can send you a private message with someone I use. 🙂

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Sent you a PM. 🙂Tapatalk thanks!

IgA is basically non-existent, under 0.1, and my IgG is slightly elevated above the normal range.
It’s all tied up with this chronic multi-regional reactive lymph node hyperplasia.

My hematologist mentioned they’d probably be sending me over to an immunologist next. Could we be looking at some kind of selective immunodeficiency? They've already ruled out ALPS for now, but I'm still waiting on the pathology results from one of the lymph nodes to see what's actually going on.

For the past week, I've been dealing with intense pain in my right kidney and urinary tract area. I saw my doctor, who sent me for urgent blood and urine tests. My bloodwork came back normal, but my urine results showed this:
Leukocytes 1-2, erythrocytes 1-2, quite a bit of squamous epithelial cells, and some bacteria. Normal range for leukocytes and erythrocytes is 0-2.
The pain just kept getting worse, so I went to the ER yesterday. Blood was fine again, but the urine showed:
Erythrocytes 2-3, leukocytes 5-10, plenty of epithelium, and some bacteria. They gave me Spasmex via IV and sent me for a urine culture. Throughout the day, I noticed some kind of tiny particles after peeing. Can anyone give me an idea of what this might be? I'm honestly terrified that it's something serious. No fever or nausea so far.

wiredpilot25 said:For the past week, I've been dealing with some pretty intense pain around my right kidney and urinary tract area. I went to see my doctor, who sent me in for an urgent urine and blood panel. My blood work came back fine, but here’s what the urine analysis showed:
Leukocytes 1-2, erythrocytes 1-2, quite a bit of squamous epithelial cells, and some bacteria. A normal range for leukocytes and erythrocytes is 0-2.
The pain actually got worse, so I ended up at the ER yesterday. Once again, my blood work was normal, but the urine results were:
Erythrocytes 2-3, leukocytes 5-10, plenty of epithelium, and some bacteria. They gave me Spasmex via IV and sent me off for a urine culture. Throughout the day, I noticed some little particles or "crumbs" after peeing. Can anyone give me a rough idea of what might be going on? I'm honestly terrified this is something serious. I haven't had any fever or nausea, though.

Look, you have a significant amount of leukocytes in your urine, which is basically the body's way of flagging an inflammation. They sent you for a urine culture specifically to identify exactly which strain of bacteria is causing the trouble. Honestly, there probably isn't much to worry about; once you get started on the right antibiotic, you'll likely start feeling much better quite quickly.