• Foreign bodies
• Fungal infection
• 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
• 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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