What does urine occult blood 2+ mean?

Urine occult blood 2+ usually indicates the presence of red blood cells, hemoglobin, myoglobin, or similar substances in the urine.

Urinary occult blood is a result from routine urinalysis. A reading of 2+ means that after centrifugation and sedimentation of the patient's urine, approximately 20 red blood cells are observed per high-power field under the microscope. Causes of hematuria include both physiological and pathological factors. Physiological causes commonly occur after intense physical exercise or in women during menstruation. Pathological causes include urinary tract infections, urolithiasis, tumors, various types of nephritis, among others. Myoglobin and hemoglobin in the urine are typically due to muscle breakdown (rhabdomyolysis) and hemolysis, respectively. Certain dietary factors or medications can also lead to a positive urine occult blood test. For instance, consuming large amounts of vitamin C may result in a false-positive occult blood result. Additionally, some medications can interfere with test accuracy, leading to false-positive outcomes.

If hematuria is present, patients should go to the hospital for a urine phase-contrast microscopy examination to determine whether dysmorphic red blood cells are present. Furthermore, tests such as 24-hour urine protein, computed tomography (CT) of the urinary tract, and ultrasound examinations can help identify the underlying cause and guide appropriate treatment.