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Having pain in right side around back. Ultrasound reported borderline hepatomegaly. Could this be infection? Remedy for pain?

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Practicing since : 2009
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I have been having right side pain that often goes around to to the back for about two weeks. At first my doctor thought it was a kidney infection and prescribed Keflex for 10 days. I am on the 9th day and the pain has gotten a little better, but I still feel a "side ache" like pain on right side and sometimes the pain is under my right rib. The pain seems to travel, but only on the right side. My doctor ordered blood tests and everything was normal. With the continuing pain, I went to see him again and he ordered an ultrasound. The ultra sound was normal (they were suspecting gallstones), but there was just a mention of borderline hepatomegaly. They were not concerned as I presume this is common, but I was wondering since the pain has not completely gone away, that maybe that could be the culprit. As I stated, the pain is very dull and has gotten better over the course of the antibiotics. If I had the pain just for one or two days, I wouldn't be concerned, but since it's lasted this long, I don't know if I should request further tests. Also, since the pain has gotten somewhat better with antibiotics, I was wondering if this could be an infection of some type or would the infection show up in blood tests? Thank you (sorry this is so "wordy")
Posted Tue, 2 Jul 2013 in General Health
Answered by Dr. Luchuo Engelbert Bain 57 minutes later
Hi and thanks for the query,

I appreciate your thoughtfulness. If the pain is going better with antibiotics, it should certainly be that there was an infectious process which is gradually clearing off. Certainly your doctor was guided by clinical parameters to suggest it was a probable kidney infection. I would strongly suggest you complete the last dose of the medication and drink lots and lots of water and fluids. Persistence of the pain or recurrence of the time should certainly warrant a new consultation.

Borderline hepatomegaly in this context should not be a major concern for now for two main reasons. First, the ultrasound is an operator dependent examination, and a borderline enlarged live should not really mean much. secondly, amelioration of clinical state on antibiotics is a clear indication there was an infectious process going on. The liver is very important in immune and inflammatory responses, and it is not unusual to have a mild enlargement of the liver which gradually goes back to normal.

I think you need not bother for now. Complete your treatment as prescribed. drink lots of water and fluids. Observe for the pain. In case of persistence or intensification for over two weeks maximum again, you might need to run the liver function tests and a reevaluation of the kidneys (urine analysis , culture and sensitivity testing). As for now, I think there is no need to be worried.

Thanks and hope this helps as I wish you the best of health. Best regards.

Bain LE, MD.

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