• Glomerulonephritis

• Foreign bodies

• Fungal infection

• Tuberculosis

• Certain drugs (e.g., cyclophosphamide)

False-positive tests occur due to contamination. False-negative results are usually due to—

• Inadequate contact of dipstick with urine

• Increased urinary specific gravity

• Glycosuria

• Presence of urobilinogen

• Ascorbic acid in urine

Therefore leucocyte esterase in isolation is insufficient to diagnose a UTI, but in conjunction with positive urinary nitrites is strongly suggestive of infection. Its use should be confined to screening urine in the asymptomatic patient in the primary care setting.

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