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What Does Elevated WBC Count Post Treatment For UTI Indicate?

Posted on Thu, 12 May 2016

Question: Hi,
My mother is 54 years old and is a diabetic patient, she is suffering from UTI since past 30 days,
previously her wbc's count in urine was 2.5-3.0 and RBC's count was 2-2.5, she was on a course of antibiotics for a week and then the Rbc's count went down to 1-1.5 and wbc's count went to 10-15, however urine culture report suggested that no organism had grown, she was given norflox 2 times a day for a week and then the wbc's count went upto 25-30, now she's been put on MIKACIN insulin for 5 days.
She is having a terrible wet cough for the past one month with no signs of improvement , worried what needs to be done next?

Answered by Dr. Dr. P. T. Patil (46 minutes later)

Brief Answer:
She has what is called as Abacterial Cystitis

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that your mother has been treated for UTI since one month and being prescribed antibiotics however her urine culture has revealed no growth of organisms in spite of the fact that microscopic examination of her urine has revealed rising trend in WBC count .

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Is her diabetes under control or not ?

This is characteristic of a Abacterial Cystitis where patient has symptoms of UTI but there are no positive evidence of infection detected either on routine urine examination or urine culture .

I would suggest to consult qualified Urologist for assessment and get following basic tests done to help to establish the diagnosis .
1) Repeat Urine culture
2) Blood sugar levels to see whether diabetes is under control or not?
3) Endoscopic Examination of Bladder (Cystoscopy)

Please continue taking Norflox in addition to Nitrofurantoin twice daily .

Ensure she drinks more water to keep her urine dilute

Consult qualified Physician or Chest Specialist for her cough problem.

Further treatment will depend upon result of these tests and final diagnosis.

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Dr. P. T. Patil (36 hours later)

Hi Dr XXXXXXX
Thanks for your answer,
her diabetes is under control.
Repeated urine culture result says 'no organism growth found'.

Also had a chest X-ray as suggested by the physician, everything seems to be good in the reports but her cough is getting worse daily.

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
She needs supportive treatent

Detailed Answer:
hello
Thanks for follow up .For her persistent cough she needs supportive treatment like
1) Frequent hot steam inhalation .
2) Breathing exercises
3) Brancho Dilators and Mucus liquefying drugs like Bromhexine .

Continue medications as per advice of your Physician .

Thanks and Regards.
Dr XXXXXXX

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar