Leukocyte esterase (++) is an abnormal condition. Leukocyte esterase is measured in urine or in blood and is divided into negative and positive in normal conditions, with normal indicators representing negative and abnormal indicators representing positive. Positivity is divided into (+), (+++), (++++) and (++++). (+) indicates the least inflammation, while (++++) indicates the most severe condition, so leukocyte esterase (++) is representative of non-normal conditions. In addition leukocyte esterase (++) usually indicates inflammatory infections, such as vaginitis, urethritis or gynecological inflammation in women, which can cause abnormalities in the above indicators. Leukocyte esterase (++) can also occur in men if they have prostatitis or urinary tract infections.