Key abnormal findings

• Leukocyte esterase: ++ and pus cells: 10-15/HPF
  Indicates white blood cells in urine, called pyuria, which commonly occurs with UTI.
• Bacteria: present
  Supports a possible bacterial UTI.
• Red blood cells: 6-8/HPF and dipstick erythrocytes positive
  This is microscopic blood in urine. It can occur with infection, stones, prostate/urinary tract problems, or other causes.
• Budding yeast present
  This may represent yeast in the urine, commonly Candida, but can also arise from sample contamination. It is more relevant in people with diabetes, recent antibiotics, urinary catheter, obstruction, or weakened immunity.
• Epithelial cells: 8-10/HPF
  Higher than expected and can mean the sample was not a perfect clean-catch specimen, so contamination is possible.

Reassuring findings

• Protein, glucose, ketones, bilirubin: negative
• Specific gravity 1.020 and pH 6: within expected range
• Nitrite negative: this does not rule out UTI, since many urinary infections are nitrite-negative.

What to do next

1. Submit a clean-catch midstream urine culture with antibiotic sensitivity, preferably before starting any antibiotic. Because yeast is reported, ask the doctor/lab whether a fungal culture or yeast identification is also needed.
2. See the treating doctor promptly, especially since this is a 75-year-old man. UTIs in men are generally assessed more carefully for prostate enlargement, obstruction, stones, catheter use, or other urinary tract issues.
3. If there are symptoms such as burning urine, urgency, frequency, lower abdominal pain, fever, chills, flank/back pain, confusion, or weakness, seek medical review today.
4. Repeat the urine examination after treatment. If blood persists, it needs further evaluation by a clinician or urologist, particularly at this age.

If it is Chlamydia

• It is a sexually transmitted infection and needs clinician-prescribed treatment.
• Sexual partner(s) should be tested and treated.
• Avoid sex until treatment is completed and partners have been treated.
• Testing for gonorrhea, HIV, and syphilis is usually advised.
• At age 75, urinary symptoms and blood in urine should also be assessed for non-STI causes such as prostate enlargement, bacterial UTI, stones, or urinary obstruction.

If it is Candida

• It is yeast in urine, not chlamydia.
• A proper repeat clean-catch urine culture with fungal identification may be needed.
• Treatment depends on symptoms and risk factors. It should not be self-treated with antibiotics, since antibiotics can worsen yeast overgrowth.