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Abnormal anti-nuclear antibody and anaemic. Done with urine cultures. Had total knee transplant. Had diarrhoea and abnormal bowels. Advise?

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Practicing since : 2001
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Hi, XXXX From Wisconsin.
I have abnormal XXXXXXX and been anemic from time to time. 2013-- I have had Urine cultures & organisms of 50,000 col/ml ENTEROCOCCUS SPECIES then Positive Fecal lactoferrin, lymphocytic colitis, 7/19/13- Urine and organisms again at 100,000 col/ml KLEBSIELLA OXYTOCA . My body temperature runs between 96, and 97.6, and has for a long time. I also just had surgery for a total knee transplant, which is doing fine. I AM 81 AND LOVE LIFE.
8/12/13 60,000 col/ml STAPHLOCOCCUS SPECIES IN MY Urine culture and organisms again. Along with this I have had diarrhea and a very abnormal bowels.. I will be happy to furnish other information if requested.
Thanks, XXXX
Posted Fri, 20 Sep 2013 in Infections
 
 
Answered by Dr. Ram Choudhary 36 minutes later
Brief Answer:
urine sample collection to be done as advised

Detailed Answer:
Hi XXXX,
Welcome to healthcare Magic!
Your urine has shown different organism growth everytime it seems that the specimen collection is not standard and you are growing contaminants.
The colony counts are also subminimal that is not clinically significant.
The sample of urine should be collected from the Foley's catheter itself and not from the drain if the patient has cather in place.
If you are not catherised then sample should be taken after local cleaning of the passage by betadine wipe and after 10 minutes a midstream sample should be collected.
Or it may be collected by passing a soft red rubber catheter in the urethra.
You should repeat the usrine sample for Routine examinaton and culture.
Anemia may be due to the disease or may be due to blood losses from gut or may be due to iron deficiency. XXXXXXX may be positive in some patients normally also.
Please let me know your brief clinical complaints to see it in clinical context.
I hope the advise would be informative and useful for you.
Take Care!
Above answer was peer-reviewed by
 
Follow-up: Abnormal anti-nuclear antibody and anaemic. Done with urine cultures. Had total knee transplant. Had diarrhoea and abnormal bowels. Advise? 2 hours later
THE URINE SAMPLES WERE TAKEN WITH BETADINE WIPES BUT I AM AFRAID I WOULD NOT HAVE ENOUGH URINE FOR A 10 MINUTE MIDSTREAM. But do catch it after urinating for a while. My XXXXXXX is not normally abnormal. I have sjogren's and I have had a chronic cough that has been getting much worse---when talking and with the tickle in my throat. I am on low dose of Thyroid medication. 25 mcg (1 1/2 pills once a day of Levothyroxin.)
With growing contaminants, is it possible that they could be coming from my colon, as I have been on antibiotics too many times this year.
 
 
Answered by Dr. Ram Choudhary 25 hours later
Brief Answer:
use antiseptic and antibacterial locally

Detailed Answer:
HiMmg...,
Welcome back to healthcare Magic!
okay, so you have already taken good precaution for collection of urine sample.
No one has amount of urine to make a flow for 10 min. i wanted to say that take the sample after 10 minutes of the betadine wipe.
Thyroid medicine is to continue and get regular thyroid hormone levels checked.
The colon and bladder are not connected so the bacteria from colon obvious can not be causative.
Frequent hospitalisation and antibiotics treatment can result in overgrowth of such bacteria on the skin and body openings.
I hope the advise would be informative and useful for you.
Take Care!
Above answer was peer-reviewed by
 
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