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Low grade fever and very tired. Clear drainage from seasonal allergies. Had UTI and took Azo test. Further tests needed?

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I have had a low grade fever for going on two weeks now--99.3-100.6. Very tired all the time. No other outward symptoms such as cough or pain. Clear drainage from seasonal allergies. I've had several UTIs this year and am not having any signs of one now. But just as a precaution I took one of the OTC Azo test with slight positive on leukocytes and negative on nitrites. I'm considering going to my nurse practitioner but not really sure she can do anything for me--maybe urinalysis and CBC. I'm 41 with no major medical issues.
Posted Wed, 23 Oct 2013 in Medicines and Side Effects
Answered by Dr. Luchuo Engelbert Bain 49 minutes later
Brief Answer:
Urine culture and sensitivity testing

Detailed Answer:
Hi and thanks for the query,

Having several UTIs and another positive urine test for nitrites and leucocytes implies persistence of an infection. I think its a good idea to identify why you are having recurrent recurrent infections. Conditions like diabetes have to be carefully ruled out for it predisposes to recurrent urinary tract infections. I suggest a urine culture and sensitivity testing first to identify the germ.

Continues tiredness is worth investigating, With a low grade fever, septicemia (bacterial infection in blood) should be ruled out. You are right by suggesting a complete blood count. A c reactive protein measurement shall indicate the degree of infection and help in monitoring therapeutic success. Other causes of low grade fever like systemic diseases (lupus) and rheumatologic conditions are important to be considered.

I suggest you book an appointment with your family physician for a complete physical examination and some tests. In case no abnormality is found at the level of the urine, detailed tests to exclude any abnormalities with the urinary tract can be searched for. Abdominal ultrasound and intravenous urography (visualize urinary system tubes) could be asked later.

I suggest a urine culture and sensitivity test first. A complete blood count, measure of C reactive protein, erythrocyte sedimentation rate are important initial steps, after a good physical examination.

Feel free asking further questions in case of need. Wishing you good health. Kind regards.

Bain LE, MD
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