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4 year old getting frequent urinary infections. Report showing pus cells in urine. What does it mean?

Dear Dr.
My Daughter is 4 years and 6 month old. 4 months ago she had UTI (With fever and lower abdominal pain) and she was treated with antibiotic . However again after 2 months she got it again(With fever and lower abdominal pain). She was put on antibiotic and her routine and urine cuture is done. Now after 10 days of antibiotic her Urine is tested and lab report says RBC 0-1 and pus cells 2-3. Doctore stopped antibiotc and asked us to give her more fluid. Her repeated Urine Culture is negetive.
as report says 2-3 pus cells do we need to worry and what should we do now????
Note: she was also treated with antibiotic many times as she has allergy asthama
Requesting you help and guidence
Asked On : Wed, 17 Apr 2013
Answers:  3 Views:  58
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Pediatrician 's  Response

Thanks for writing to health care magic.

Repeated urinary infection can occur because of congenital anomalies of urinary tract.

So if a child is getting recurrent urinary tract infections he should be investigated with ultrasound abdomen and if required a MCU and DMSA scan.

Pus cells of 2-3 in hpf.... Pus cells above 10 in hpf indicate infection. Less than that is not suggestive of infection.

Allergies like asthma do not require antibiotics regularly. Antibiotics are useful only if there is bacterial infection.

Hope this helps.
Take care.
Answered: Wed, 17 Apr 2013
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Pediatrician Dr. Rajiv K Khandelwal's  Response

Thank you for your query.

The report is good and you should not worry. However you need to take the following precautions/actions:
1. Make her drink plenty of oral fluids.
2. Ensure good personal hygiene.
3. Get urine routine test done at regular intervals to ensure that asymptomatic infection is not missed out.
4. Occasionally get her urine culture done.

I hope I have answered your query to your satisfaction.

Wishing your daughter all the best.


Rajiv K Khandelwal
Answered: Wed, 17 Apr 2013
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General & Family Physician Dr. Achuo Ascensius's  Response
thanks for using health care magic

Repeated urinary infections could be an indication of a urinary tract abnormality which favors the development of such infections. This is particularly common in children and especially in girls who are more predisposed to urinary infections than boys. A urinary tract ultrasound or CT scan is therefore needed to evaluate the urinary tract for abnormalities and for appropriate measures if there is an abnormality.
Since you indicated that she was given antibiotics following a urine culture, then it is certain after the 10 days of antibiotics that the infection has been taken care off. More so, the urine culture didn't isolate any germ and urine analysis had just 2-3 pus cells which is normal giving that she is recovering from an infection.
However, her clinical picture is very important. If the symptoms which she presented prior to treatment got finish 48 to 72hours after treatment, its an indication that the treatment was effective; on the other hand, if it took a couple of days for the symptoms to rather reduce and still are persistent, then the infection was not cleared off.
Hope this helps you.
Dr Achuo
Answered: Wed, 17 Apr 2013
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