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Significance of UTI - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Urinary and Bladder Problems
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2234 Questions
User :   Hi,My son has been diagnosed with ALL L1, and Chemo was started on 15th Feb 2010, with Protocol UKALL MRC 97. His age is 4 years 6 months
His Induction and first intensive phase is over, doc has confirm complete remission also.
Intensive phase was over on 20th March, after 4-5 days, he start having fever,
Doc start saying this could be because of low WBC, Now WBC has become to 11000, and all infections reports are -ive, but still fever persist. Next cycle of Chemo is getting delay because of fever.
Please advice !
Doctor :   hi
User :   Hi
Doctor :   Dr. XXXXXXXX here.Let me read what you have typed.
User :   ok
Doctor :   I think that for your case we will need to take the opinion of our panel of specialists. I am not the right person to answer this. I am a gereral practioner
Doctor :   I can provide you with our panel specialist opinion to solve your query
User :   ok
Doctor :   you can visit this links to take our panel specialist opinion
User :   Thank you
Doctor :   you can send your sons's reports at, and we will have them looked at by the specialists
Doctor :   have you followed what I have suggested?
User :   ok
Doctor :   Is there any thing else I can help you with?
User :   I will scan and send you the complete report
User :   I am visiting their profile
Doctor :   sure you can send them to us anytime
Doctor :   and take your time to decide whom you would like to consult
Doctor :   and then get back to us, and we wil assist you further with it
User :   ok
Doctor :   you can also contact our CRM team on 080-XXXXXX
Doctor :   for any assistance that you would require
User :   Sure
User :   Could you tell me what is significance UTI
Doctor :   Do you mean to as Urinary Tract Infection?
User :   yes
Doctor :   if yes, it means that the urine infection is present and could be a cause for fever not coming down
User :   yesterday we have done the Urine test, and in that test we found 70 -80 pus cell
Doctor :   ok
Doctor :   then a further urine culture and senstivity should be done
Doctor :   to see which organism is responsible for infection
Doctor :   and also which antibiotic wil be best suited to fight it
User :   we have send the sample for urine culture
Doctor :   and then depending on teh results, the treatment should be proceeded
Doctor :   ok
Doctor :   when are the results expected?
User :   right now doc are giving monocef
Doctor :   is he already been started on antibiotics after giving the sample?
User :   and augmetine
User :   yes
Doctor :   ok, Monocef covers most of the resistant organisms. is the fever coming under control after starting monocef?
Doctor :   and augmentin?
User :   not really
User :   Augmentin
Doctor :   then waiting for the results and starting the antibiotics to which the organism is susceptible would be better
Doctor :   as then the fever wil get under proper control.
User :   if urine culture comes -ive
User :   then should be the next step
Doctor :   since pus cells were present in urine, infection is suggestive.
Doctor :   so we have to wait for the results
Doctor :   if the culture comes negative, then the source of the puss cells will need to be further investigated
Doctor :   using imaging techniques to visualise inside of baldder
Doctor :   to see if any cystitis is occured that is
Doctor :   responsble for the pus cells
Doctor :   have you followed what i have said?
User :   what else can produce the pus cell in urine
User :   Yes i will do it
Doctor :   any infection in the urinary tract involving kidney, ureter, bladder, urethra can lead to puss cells in urine
Doctor :   so next step would be to rule out infections in any of these sites, but first the culture report should be seen
User :   ok
Doctor :   it should identify infection in these sites also
Doctor :   is there anything else you would like to ask me?
User :   you means culture report will rule out the source of pus cell among all these also
Doctor :   it should as is will see if the organism is present or not and urine is drained from kidney via ureter to bladder and from bladder via urethra to outside
Doctor :   so any infection if present in any of above sites shold get idenified
User :   ok
Doctor :   and the treatment given will be to cure infection from all these sites
User :   protein also has come ++
User :   in urine test
Doctor :   proteins will be present if any infection or fever is present even in normal individuals.
User :   how long it takes to recover UTI
Doctor :   it depends on the organism causing it
Doctor :   the usual time period for treating UTI can vary from 5 -14 days
Doctor :   if infection is chronic, it can take upto a month also
User :   oh
Doctor :   hence i suggest you to wait for the reports to come
Doctor :   and do not assume anything
User :   Could please tell me some thing about CMV PP 65 test
User :   one of doc has suggested to do the same
Doctor :   it is an is a immunofluorescence test
Doctor :   in which the CMV pp65 antigen is tested
Doctor :   to see if Cytomegalovirus infection is present
User :   What about the treatment, if that comes +ive
Doctor :   if it comes out positive, then the treatment will be to cure from cytomegalovirus infections
Doctor :   by giving
Doctor :   immunoglobulin to treat the infection
Doctor :   sometimes it is also combined with antivirals
Doctor :   in patients who have reduced immunities
User :   should we go for this test
Doctor :   wait for culture results, if it comes negative, or suggests mild infection, then go for this test
Doctor :   as this might be causing the fever not to come down
User :   Today they have suggested the to do HDCT scan
User :   of chest
Doctor :   and also the broad spectrum antibiotics not working.
Doctor :   ok
User :   what kind of infection can be rule out through HDCT scan
Doctor :   CT scan of chest wil reveal any chest infections or damage to lungs or other structures in chest
Doctor :   and high density sacn will show even minute changes
Doctor :   why was HDCT of chest advised?
Doctor :   what symptoms does your son have at present apart from fever?
User :   nothing
User :   only fever
Doctor :   ok
User :   even they have started the Voritek also
User :   x-ray has come normal
User :   he has fever from last 22 days
Doctor :   ok
User :   and doc are not able to identify till day before yesterday
Doctor :   what is the temperature reading?
User :   so they were trying all antibotics and anit fungul
User :   it goes up to 104 some time
Doctor :   since his immunity was low at some point of time, any infection would have set in
Doctor :   and the doctors now woul dtry to rule out infection from all susceptible regions of body
Doctor :   like lungs and urinary tract
User :   we have done the urine test in the past
Doctor :   espcially for viral infections as they set in the most easily in immunocompromised individuals
User :   but that time report was normal
User :   I just trying to understand it that UTI is real cause of fever or not
User :   or it is something else
User :   We are loosing time to identify the cause and chemos are getting delay
Doctor :   the cause of fever can be due to anything and any infection anywhere in body, the most common being urine or lung infection in this scenario
User :   we are very worry about tje same
Doctor :   hence the tests are focussed on these two areas more
Doctor :   do not worry, wait for th eresults, and go ahead with further tests to identify cause for fever
Doctor :   and get it treated
Doctor :   such that the next cycle of chemotherapy can be started
Doctor :   as early as possible.
Doctor :   Is there any thing else you would like to ask me?
Doctor :   have you followed what I have said?
User :   No Thanks
User :   Thank you very much for the information
User :   I will get back to you
Doctor :   sure you can get back to me anytime 24/7
User :   Thanks
User :   bye
Doctor :   Please fill the feedback form say done when done
Doctor :   Thanks for consulting me. Bye for now. Please chat with our doctors 24/7 for medical queries. Please refer your friends to our service.
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