Brief Answer: Proteus infection needs management Detailed Answer: Thank you for asking! Proteus infections are the most common community acquired infection and 90 percent of cases of proteus infections are caused by mirabilis species.you would be amazed to know that Proteus species are most commonly found in the human intestinal tract as part of normal human intestinal flora, along with Escherichia coli and Klebsiella species, of which E coli is the predominant resident but the very same normal resident once reaches urinary tract it leads to infection and individuals in long-term care facilities and hospitals and from patients with underlying diseases or compromised immune systems are very much prone to this infection.Also those who have had urethral instrumentation or any other intervention of urinary tract and those whose infections were acquired in the hospital have an increased frequency of infection caused by Proteus and other organisms (eg, Klebsiella, Enterobacter, Pseudomonas,enterococci, staphylococci). You should get a simple radiological work up like Ultrasound etc to rule out any struvite stones or renal abscess or pyelonephritis which is a common complication of such UTis and it might need surgical intervention to drain them and remove the stone. Recommended empirical treatment includes the following: 1)Uncomplicated UTIs in women can be treated on an outpatient basis with an oral quinolone for 3 days or trimethoprim/sulfamethoxazole (TMP/SMZ) for 3 days. 2)Acute uncomplicated pyelonephritis in women can be treated with oral quinolones for 7-14 days, single-dose ceftriaxone or gentamicin followed by TMP/SMZ, or an oral cephalosporin or quinolone for 14 days as outpatient therapy. For hospitalized patients, therapy consists of parenteral (or oral once the oral route is available) ceftriaxone, quinolone, gentamicin (plus ampicillin), or aztreonam until defervescence. Then, an oral quinolone, cephalosporin, or TMP/SMZ for 14 days may be added to complete treatment. 3)Complicated UTIs can be treated with a 10- to 21-day course of oral therapy (in the same manner as for hospitalized patients) as long as the follow-up is adequate. You are just having cephalexin and it needs more than that to get this Proteus infection out of the system. Good toilet hygiene and increase intake of garlic, plenty of fluids and use of cranberry juices and intra bladder instillation of hyaluronic acids are also helpful. Consult with a urologist for further management and let him help you with the management. I hope it helps. Dont forget to close the discussion please. Take care S Khan

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