Final answer:
If a patient displays central/left abdominal pain with sterile pyuria, it indicates a non-bacterial inflammatory process in the urinary tract, such as viral infections or interstitial cystitis, requiring further comprehensive diagnostic tests for proper treatment.
Step-by-step explanation:
If a patient has central/left abdominal pain but no bacteria or nitrites in the urine (sterile pyuria), then the pathology is probably due to a non-bacterial process. Sterile pyuria indicates the presence of white blood cells in the urine without the presence of bacteria, suggesting an inflammation that is not due to a bacterial infection. Possible causes include viral infections, interstitial cystitis, tuberculosis, or nephritis among others. Even though the patient's symptoms, such as high fever and bloody urine, may suggest a urinary tract infection (UTI), the absence of bacteria or nitrites after a urine culture could point towards other pathologies, or, a UTI caused by non-nitrite producing organisms. For instance, pyelonephritis can cause severe kidney infection without the presence of nitrite if caused by organisms that do not reduce nitrate. Comprehensive diagnostic tests, including urine cultures and imaging, are crucial for accurate diagnosis and targeted treatment.